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ANIMAL  EXPEREMENTATION 
AND  MEDICAL  PROGRESS 


ANIMAL  EXPERIMENTATION 

AND 
MEDICAL  PROGRESS 


BY 


WILLIAM  WILLIAMS  KEEN,  M.D.,  LL.D. 

PROFESSOR  EMERITUS  OF  SURGERY,  JEFFERSON  MEDICAL 
COLLEGE,   PHLLADBLPHLA 


WITH   AN  INTRODUCTION   BY 
CHARLES   W.   ELIOT,  LL.D. 

PRESIDENT  EMERITUS  OF  HARVARD  UNIVERSITY 


BOSTON   AND  NEW  YORK 

HOUGHTON  MIFFLIN  COMPANY 

^te  liitjer^ibe  ^xt0  Camtirib0e 

1914 


COPYRIGHT,   1914,  BY  WILLIAM  WILLIAMS  KEEN 
ALL   RIGHTS   RESERVED 

Published  November  iqi4 


K26 


PREFACE 


I  HAVE  been  so  frequently  asked  by  earnest  inquirers 
after  truth  for  information  as  to  animal  experimentation, 
and  especially  for  my  own  publications,  that  I  have  con- 
cluded to  publish  these  papers  in  a  more  permanent  and 
accessible  form  than  in  medical  and  other  journals.  My 
thanks  are  due  to  the  editors  and  pubhshers  of  the  journals, 
etc.,  in  which  these  papers  first  appeared,  for  permission 
to  republish  them  in  this  volume. 

The  papers  appear  in  chronological  order.  Hence  it  is 
important  that  all  their  statements  of  methods,  results, 
and  statistics  should  be  considered  in  connection  with  the 
date  of  the  publication  of  each  paper.  In  some  cases  I  have 
given  in  footnotes  later  information  and  statistics. 

One  rather  serious  objection  to  repubUshing  these  papers 
in  full  and  just  as  they  were  written  is  that  there  is  consid- 
erable repetition.  But  it  must  be  remembered  that  they 
were  published  or  delivered  at  various  times  in  many 
years  and  that  they  were  read  or  heard  by  very  different 
sets  of  readers  or  hearers.  Naturally  I  wished  each  address 
or  paper  to  be  complete  in  itself.  Moreover,  a  potent  reason 
for  the  repetitions  is  that  they  were  intended  to  meet  the 
constantly  repeated  misstatements  by  the  opponents  of 
experimental  research  in  spite  of  pubhc  exposure  of  these 
misstatements.  This  is  well  illustrated  by  the  case  of 
Dr.  Wentworth,  which  is  fully  stated  on  pages  274-278. 

I  have  frequently  used  the  word  "vivisection."  It  is 
very  objectionable,  however,  for  its  meaning  is  usually 
extended  to  cover  experiments  on  the  effects  of  the  varied 
and  difficult  problems  connected  with  nutrition  and 
physiological  chemistry;  experiments  to  determine  the 
effects  of  "drowning,"  whether  the  submersion  be  of  longer 


'iiii)u 


vi  PREFACE 

or  shorter  duration,  fatal  or  non-fatal,  and  the  value  of 
various  methods  of  resuscitation;  hypodermic  injections  of 
various  drugs,  etc.  None  of  these  involve  any  "cutting 
of  a  living  animal"  as  "vivisection"  actually  means.  Only 
about  six  per  cent  of  all  the  experiments  on  animals  in 
England  (and  the  same  percentage  would  hold  good  of 
America)  are  strictly  "vivisections,"  and  over  one  half  of 
these  animals  were  killed  before  regaining  consciousness. 

Every  surgical  operation  is  literally  a  "human  vivisec- 
tion." In  such  operations  we  always  take  it  for  granted 
that  an  anesthetic  has  been  used,  even  though  no  mention 
of  it  is  made  by  the  operator. 

But  the  "antivivisectionists"  constantly  quote  descrip- 
tions of  operations  on  animals  omitting  all  mention  of  the 
anesthetic,  and,  therefore,  lead  their  readers  to  beheve  that 
they  were  done  without  an  anesthetic.  Yet  in  the  very 
papers  from  which  these  descriptions  are  taken  the  authors 
distinctly  state  that  an  anesthetic  was  given. 

In  their  leaflet  entitled  "The  Anesthetic  Delusion,"  for 
example,  experiments  by  Crile  are  thus  quoted:  — 

Other  experiments  are  described  such  as  "tearing  and  twisting 
the  sciatic  nerve";  "extirpation  of  an  eye  and  rude  manipulation 
and  bruising  of  the  socket";  "forcing  air  and  then  water  into  the 
stomach,  causing  its  gradual  complete  dilation,  and  its  final 
bursting."  —  From  *'  Surgical  Shock,"  by  Dr.  Crile. 

No  mention  is  made  of  any  anesthetic.  Yet  every  one 
of  these  animals  was  anesthetized. 

A  still  more  flagrant  instance  occurs  in  a  letter  by  Mrs. 
Henderson,  vice-president  of  the  American  Antivivisection 
Society,^  in  which  she  asserts  that  "Dr.  Crile's  book  .  .  . 
repeatedly  describes  experiments  followed  by  the  words 
*no  anesthesia.' "  Dr.  Crile  answered  this  charge  by  saying 
that  in  not  a  single  instance  do  these  words  appear  in  his 
book. 

1  Philadelphia  Ledger,  December  19, 1913. 


PREFACE  vii 

After  a  careful  examination  of  the  book  myself,  I  could 
find  no  such  words  anywhere.  On  the  contrary,  I  found 
that  Dr.  Crile  alluded  some  forty  times  to  the  anesthetic 
given  to  the  animals,  and  on  pages  137  and  146,  two  sec- 
tions appeared  covering  a  page  and  a  haK  with  the  heading, 
in  capitals,  "ANESTHESIA." 

Besides  this,  on  page  14  of  the  same  book,  it  is  distinctly 
stated  that  "In  all  cases  the  animals  were  anesthetized, 
usually  by  the  use  of  ether,  occasionally  by  chloroform, 
either  alone  or  with  ether.  In  a  few  cases  curare  and  mor- 
phine were  used." 

I  have  four  times  written  Mrs.  Henderson  and  chal- 
lenged her  to  give  me  the  pages  on  which  these  words 
appeared,  but  though  these  pages  were  explicitly  promised, 
she  has  failed  to  send  them.  "Harper's  Weekly"  for  May 
16,  1914  (page  13),  states  that  Mrs.  Henderson  had  prom- 
ised the  editor  "months  ago"  to  specify  these  pages,  and 
had  been  reminded  of  the  promise  several  times,  but  no 
such  information  had  been  furnished  him. 

How  the  profession  esteems  Dr.  Crile  is  shown  by  his 
most  recent  honor  —  the  award  to  him  of  the  American 
Medicine  Gold  Medal  for  1914,  as  the  American  physician 
who,  in  the  judgment  of  the  trustees,  has  performed  the 
most  conspicuous  and  noteworthy  service  in  the  domain  of 
medicine  and  surgery. 

In  my  paper  on  "The  Influence  of  Antivivisection  on 
Character  "  in  this  volume,  I  have  shown  how  false  is  the 
assertion  that  "light  anesthesia"  means  "sensibility  to 
pain."  Every  busy  surgeon,  in  countless  operations  on 
human  beings,  knows  that  patients  often  struggle  when  the 
first  incision  is  made,  showing  that  the  anesthesia  is  not 
deep  enough  to  prevent  muscular  response.  Yet,  even 
though  the  struggles  may  have  been  very  violent,  the  pa- 
tient on  returning  to  consciousness  has  been  in  entire 
ignorance  even  that  an  operation  has  been  done. 

Operations  done  on  animals  before  even  the  discovery  of 


viu  PREFACE 

anesthesia  by  ether  (first  pubKcly  used  on  October  16, 
1846)  are  described  by  the  antivivisectionists  without 
stating  the  date  or  the  fact  that  anesthesia  was  then  im- 
known,  and  the  reader,  unversed  in  medical  history,  sup- 
poses that  these  operations  are  done  at  the  present  time. 

In  no  illustration  by  drawing,  photograph,  painting,  or 
model  shown  at  the  antivivisection  exhibitions  have  I  ever 
seen  the  representation  of  an  etherizer  administering  an 
anesthetic.  Such  illustrations  are  utterly  untrustworthy 
and  misleading.  Even  impossible  operations  are  shown  as 
though  they  were  commonly  done,  instead  of  being  simply 
absurd. 

One  of  the  commonest  assertions  of  the  antivivisection- 
ists is  that  all  experiments  are  done  behind  "closed  doors," 
locked  and  barred,  and  guarded  against  the  intrusion  of 
any  outsider.  Dr.  R.  M.  Pearce,  of  the  University  of 
Pennsylvania,  1  has  fully  answered  this.  I  can  only  quote 
one  paragraph :  — 

At  an  exhibit  of  the  American  Antivivisection  Society  two 
years  ago.  Dr.  Allen  J.  Smith,  then  Dean  of  the  Medical  School, 
in  conversation  with  Mrs.  Easby,  offered  to  allow  her  the  freedom 
of  the  University  laboratories  and  animal  house,  and  later 
(February  21, 1912)  wrote  Mrs.  Easby  reminding  her  of  this  offer. 
These  invitations  were  of  no  avail,  for  no  member  of  the  Society 
has  either  officially  or  in  a  private  capacity  visited  the  University 
laboratories.  Despite  this  effort  on  our  part,  Mrs.  Easby,  at  the 
recent  exhibit,  assured  one  of  the  sight-seers  that  entrance  to 
experimental  laboratories  was  impossible,  and  with  this  coupled 
the  statement  that  anesthesia  was  not  used  in  any  of  the  opera- 
tions. As  it  happened,  the  young  woman  to  whom  these  state- 
ments were  made  was  our  operating-room  nurse,  who  not  only 
has  charge  of  every  operation,  but  administers  the  anesthetic 
and  knows  how  frequently  strangers  come  not  only  into  the 
laboratory,  but  as  well  into  the  operating-room  itself. 

It  is  highly  diverting  that  the  statement  of  Mrs.  Easby, 
"that  anesthesia  was  not  used  in  any  of  the  operations," 
1  Old  Penn,  January  9,  1914. 


PREFACE  ix 

was  unknowingly  made  to  the  very  young  woman  who  was 
constantly  anesthetizing  these  very  animals ! 

Dr.  W.  B.  Cannon,  Professor  of  Physiology  in  the  Har- 
vard Medical  School,  writes  me  as  follows:  "None  of  the 
doors  in  my  laboratory  are  locked.  Any  one  could  come  in 
at  any  moment." 

The  constantly  reiterated  cry  of  "human  vivisection" 
to  rally  the  public  against  experimental  research  has  of  late 
been  the  chief  resource  of  the  antivivisectionists. 

In  Dr.  R.  M.  Pearce's  article,  "The  Charge  of  Human 
Vivisection  as  Presented  in  Antivivisection  Literature,"  in 
the  series  of  pamphlets  issued  by  the  American  Medical 
Association^  there  is  a  full  consideration  of  the  American 
cases  of  alleged  human  vivisection,  and  in  my  own  papers  on 
"The  Misstatements  of  the  Anti vivisectionists " ^  the  for- 
eign cases  will  be  found. 

I  may  especially,  however,  allude  to  the  evidence  of  the 
cruelty  of  the  antivivisectionists  as  shown  in  the  attack 
that  has  been  made  upon  the  researches  of  Drs.  Mitchell, 
Morehouse,  and  myself  as  set  forth  on  page  236.  Ap- 
parently these  cruel  persons  would  have  forbidden  us  to 
seek  any  relief  for  those  suffering  soldiers  during  the  Civil 
War  by  testing  the  effects  of  any  drugs  upon  them.  For 
these  humane  efforts  to  alleviate  their  horrible  sufferings, 
Drs.  Mitchell,  Morehouse,  and  myself  are  to  this  day  held 
up  to  the  execration  of  our  fellows  as  guilty  of  "human 
vivisection." 

Now  let  us  look  the  facts  squarely  in  the  face. 

While  animals  have  benefited  enormously  from  experi- 
mental research,  the  chief  object  has  been  to  benefit  the 
human  race,  to  diminish  suffering,  baffle  death,  and  save 
the  bread-winner  to  his  family  or  the  loved  children  and 
others  to  their  relatives.  In  some  cases  a  whole  nation  and 
the  world  have  experienced  the  benefits.  No  better  in- 
stances could  be  cited  than  the  abolition  of  yellow  fever, 
*  See  list  on  pp.  xix,  xx.  *  See  pp.  110  and  135. 


X  PREFACE 

the  total  disappearance  of  "hospital  gangrene,"  and  the  al- 
most total  abolition  of  tetanus  (saving  in  neglected  cases). 
The  Panama  Canal  has  been  made  a  possibility;  from 
our  Southern  cities  have  been  banished  the  frightful  epi- 
demics of  yellow  fever  which  impoverished  them  by  thou- 
sands of  lives  and  millions  of  dollars;  malaria  bids  fair  to  be 
conquered;  typhoid  fever,  one  may  say,  has  disappeared 
from  our  armies  and  is  being  conquered  in  civil  life.^ 

In  the  papers  pubKshed  in  this  volume,  I  have  shown 
some  of  the  victories  which  have  been  won.  How  has  this 
marvelous  progress  been  made?  I  answer,  "By  experi- 
ment." Go  back  to  my  early  professional  life  fifty  years 
ago.  Yellow  fever,  malaria,  hospital  gangrene,  tetanus, 
and  typhoid  were  national  scourges.  Only  three  ways  are 
open  to  lessen  or  abolish  these  and  other  diseases:  — 

1.  Try  a  new  remedy  or  method  or  operation  and  try 
it  first  on  man.   God  forbid! 

Yet  Mrs.  White,  the  most  prominent  Philadelphia  anti- 
vivisectionist,  is  a  pronounced  advocate  of  human  vivisec- 
tion. ^ 

2.  Try  them  first  on  the  lower  animals  and  then  on  man, 
provided  that  the  trials  on  animals  showed  that  they 
would  be  an  improvement  upon  existing  methods.  If  such 
trials  on  animals  proved  that  they  were  ineffective  or  dan- 
gerous, then  they  would  not  be  tried  on  man  at  all. 

3.  Try  no  experiments  at  all  either  on  animals  or  man, 
that  is  to  say,  never  make  any  progress. 

Remember  that  the  least  deviation  from  the  usual  prac- 
tice, whether  in  using  a  new  drug  or  even  a  larger  or  a 
smaller  dose,  or  in  a  different  way,  is  an  "experiment." 
For  instance,  hypodermic  injections,  which  were  unknown 
till  about  fifty  years  ago;  puncturing  the  spinal  canal, — 
"lumbar  puncture," — in  order  to  make  a  diagnosis  and 
later  to  inject  a  remedy,  was  unknown  until  a  little  over 

1  See  footnote,  p.  260. 

2  See  text,  pp.  251-253,  and  254  and  footnote,p.  252. 


PREFACE  xi 

twenty  years  ago  and  has  only  become  a  routine  practice 
within  the  last  few  years;  and  many  new  and  valuable 
drugs  have  been  thus  introduced  into  our  ordinary  practice. 
Every  one  of  these  at  first  was  an  "experiment.'* 

I  am  sure  that  every  person  of  common  sense  could  only 
choose  the  second  of  these  three  possibilities. 

"Clinical  observation"  is  constantly  vaunted  by  the 
antivivisectionists  as  the  proper  and  best  method  of  prog- 
ress. As  a  clinical  teacher  for  over  forty  years,  I  would 
be  the  last  to  decry  this  method  of  progress.  But  the  mo- 
ment you  act  on  your  "clinical  observation"  by  any  new 
method  of  treatment,  any  new  dose  or  drug,  any  new  or 
even  slightly  varied  operation,  you  are  making  an  experi- 
ment and  on  a  human  being.  If  your  treatment,  dose,  drug, 
or  operation  is  so  slight  a  variation  that  you  may  rightly 
venture  to  use  it  without  testing  it  on  an  animal  first,  very 
well.  But  if  you  do  so,  you  have  nevertheless  done  an 
experiment  upon  a  human  being.  If  the  departure  from 
prior  practice  is  so  great  as  to  involve  possible  serious 
results,  then  I  hold  that  you  have  no  right  to  try  it  upon  a 
human  being  first  if  it  is  possible  first  to  test  it  on  an 
animal. 

Look  for  a  moment  at  the  difference  between  the  results 
of  clinical  observation  and  of  experimental  investigation 
in  syphilis.  Of  course,  no  experiments  on  human  beings 
were  allowable.  Metchnikoff  in  1903  first  succeeded  in 
inoculating  the  disease  in  apes  and  later  in  other  animals. 
Experiments,  impossible  before  that  time,  were  immedi- 
ately begun  on  animals.  In  1905  Schaudinn  and  Hoffmann 
thus  discovered  the  germ.  In  1910,  after  a  most  extraordi- 
nary series  of  experiments  with  six  hundred  and  five  other 
remedies,  which  had  to  be  discarded  as  ineffective  or  too 
dangerous,  Ehrlich  discovered  his  Salvarsan,  or  "606,"  since 
which  time  we  have  had  the  whip-hand  over  this  desolat- 
ing plague.  Many  of  the  victims  of  this  dreadful  disease 
are  innocent  women;  many  others  are  innocent  children. 


xii  PREFACE 

some  already  dead  when  born;  others  destined  happily  to 
an  early  grave;  still  others,  less  fortunate,  doomed  to  drag 
out  a  miserable  existence. 

In  seven  years  experiment  on  animals  did  more  for  alle- 
viating human  misery  from  this  one  disease  than  clinical 
observation  on  man  had  done  in  over  four  centuries. 

The  objection  is  constantly  made  that  animals  are  so 
differently  constructed  from  man  that  inferences  from 
results  on  animals  are  of  no  value  in  the  case  of  man.  That 
there  are  a  few  and  even  sometimes  marked  differences  is 
perfectly  true,  as,  for  example,  the  effect  of  belladonna  or 
of  opium  on  man  and  on  some  of  the  lower  animals;  but 
as  a  matter  of  fact,  barring  these  few  exceptional  cases, 
the  organs  and  functions  of  man  and  animal  correspond 
exactly  in  health  and  in  disease,  and  the  effects  of  drugs 
and  operations  are  parallel  and  in  most  cases  are  iden- 
tical. 

The  antivivisectionists  claim  the  support  of  a  large 
number  of  doctors.  Undoubtedly,  they  have  a  moderate 
number,  but  they  are  chiefly  unknown  in  the  profession. 
A  very  few  are  or  were  really  men  of  distinction.  Profes- 
sor Henry  J.  Bigelow,  who  was  born  nearly  a  century  ago 
(1818),  the  early  part  of  whose  professional  life  was  past 
before  anesthesia  was  known,  was  familiar  with  the  dread- 
ful sufferings  of  the  animals  at  Alfort  in  France,  and  his 
very  proper  protest  against  it  is  constantly  used  by  the 
antivivisectionists.  In  his  later  life,  however,  when  anes- 
thesia was  well  established,  he  published,  in  the  same 
volume  from  which  their  quotations  are  taken,  an  in- 
dorsement of  experiment  by  research  which  the  antivivi- 
sectionists always  fail  to  quote. ^ 

Lawson  Tait  was  undoubtedly  a  good  surgeon  and  dis- 
tinguished in  his  early  life.  But  the  reUability  of  his  sta- 
tistics was  seriously  questioned.  He  was  much  of  an 
Ishmaelite  in  his  profession,  and  the  last  years  of  his  life 
1  See  pp.  278,  293. 


PREFACE  xiii 

closed  in  pitiable  obscurity.  He  is  constantly  quoted  by 
the  antivivisectionists  as  a  vigorous  opponent  of  experi- 
mental research.  In  fact  he  is  their  "trump  card."  But, 
for  evident  reasons,  they  never  allude  to  his  recantation  ^ 
six  years  before  his  death  in  1899. 

On  February  2, 1893,  at  a  conjoint  meeting  of  the  Mid- 
land Medical  Society  and  the  Birmingham  Branch  of  the 
British  Medical  Association,  to  consider  the  objects  of  the 
British  Institute  of  Preventive  Medicine  (now  the  Lister 
Institute)  and  to  further  the  same,  the  following  resolution 
was  passed:  — 

Resolved,  That  the  members  of  the  medical  profession  in 
Birmingham  [Mr.  Tait's  home]  and  district  cordially  approve  of 
the  objects  of  the  British  Institute  of  Preventive  Medicine. 

Mr.  Tait  spoke  in  favor  of  the  resolution,  saying  that  he 
fully  assented  to  the  resolution,  feeling  that,  while  he 
objected  to  a  certain  class  of  surgical  investigations,  **  bac- 
teriological experiments  on  animals  had  proved  of  great  value  " 
(italics  mine).  Yet  the  antivivisectionists  still  flatly  deny 
that  bacteriology  is  true  or  has  proved  of  any  value  what- 
ever. The  report  adds  that  "this  declaration  of  Mr.  Tait 
was  received  with  amusement  and  applause." 

Another  oft-quoted  authority  against  experimental  re- 
search is  Sir  William  Fergusson,  of  London.  He  was  an 
eminent  surgeon  in  his  day.  He  died  m  1877,  just  as  the 
new  era  in  medicine  (that  of  modern  experimental  research 
and  antisepsis)  was  beginning, —  an  era  which  has  wit- 
nessed the  most  wonderful  progress  ever  seen  in  every 
department  of  medicine. 

To  quote  the  opinions  of  these  men  —  Tait  (especially 
in  view  of  his  recantation),  Bigelow,  and  Fergusson — men 
"who  died  fifteen,  twenty-four,  and  thirty-seven  years  ago 
—  against  the  opinions  of  similar  leaders  in  medicine 
to-day,  is  like  citing  the  opinions  of  eminent  engineers  of 
1  British  Medical  Journal,  1893,  vol.  i,  p.  317. 


xiv  PREFACE 

the  last  century  as  to  the  methods  and  even  the  possibility 
of  constructing  the  Panama  Canal,  against  the  opinions 
and  achievements  of  Colonel  Goethals  and  Colonel  Sibert. 

The  recent  prosecution  of  six  professors  of  the  Univer- 
sity of  Pennsylvania  for  cruelty  to  animals  was  a  notable 
event,  especially  by  reason  of  the  charge  to  the  jury  by 
Judge  Bregy.  The  learned  judge  ruled  that  "the  law  of 
Pennsylvania  does  not  allow  pain  and  suffering  or  torment 
or  torture  to  be  inflicted  upon  dogs  for  any  purpose  except 
for  the  relief  of  the  suffering  of  the  dog  itself."  By  impUca- 
tion  the  word  "dog"  is  used  in  a  general  sense  for  "ani- 
mal" or  "living  creature." 

In  the  opinion  of  Samuel  Dickson,  Esq.,  the  Nestor  of  the 
Philadelphia  Bar,  furnished  to  the  Trustees  of  the  Univer- 
sity, it  is  pointed  out  (1)  that  this  opinion  "is  in  conflict 
with  what  has  been  the  common  understanding  of  the 
people  of  this  Commonwealth  for  centuries  and  with  the 
implications,  at  least,  if  not  the  express  language,  of 
the  Acts  of  Assembly  upon  the  subject  and  the  decision  of 
the  Supreme  Court  "  of  Pennsylvania.  (Commonwealth  vs, 
Lewis,  140  Pa.  261.)  (2)  Mr.  Dickson  then  points  out 
some  of  the  consequences  which  would  follow  this  construc- 
tion of  the  law.  Thus  the  gelding  of  the  caff,  colt,  dog, 
pig,  or  chicken  to  increase  its  size  and  value  for  food,  or  to 
make  the  animal  more  tractable  as  a  beast  of  burden;  the 
playing  of  a  game  fish  on  the  hook  in  some  cases  for  hours; 
the  shooting  of  birds  —  unless  they  are  instantly  (i.e., 
painlessly)  killed  —  would  be  illegal  and  punishable  as  a 
"crime";  for  all  this  is  done  not  for  the  "relief  of  the  dog 
itself,"  but  for  the  convenience  of  man. 

Nay,  more,  if  followed  to  its  logical  end,  would  it  not  be 
illegal  even  to  net  fish  as  a  business,  for  they  are  suffocated 
by  their  removal  from  water  and  are  thus  "tortured,"  not 
for  their  benefit,  but  for  our  food.  Would  it  not  also  be  ille- 
gal to  poison  or  trap  a  rat  —  even  if  the  plague  were  at  our 
doors  —  or  a  mouse  if  the  house  is  invaded;  to  starve  the 


PREFACE  XV 

typhoid-carrying  fly  in  a  trap  or  on  "tanglefoot"  paper;  to 
poison  even  a  roach,  though  its  instant  death  underfoot 
would  be  allowable? 

This  trial  resulted  in  a  disagreement  of  the  jury.  It  is 
understood  that  the  prosecution  has  abandoned  any  fur- 
ther proceedings. 

The  prosecution  has  produced  two  good  results:  — 

(1)  A  special  committee  of  the  Board  of  Trustees  of  the 
University  made  a  careful  and  detailed  examination  of  the 
Departments  of  Medicine  involving  animal  experimenta- 
tion, their  methods,  rules,  care,  and  food  of  the  animals,  con- 
dition of  the  Animal  House,  etc.,  and  in  their  report  com- 
pletely exonerate  the  teachers  from  all  charges  of  cruelty. 

(2)  The  press,  especially  of  Pennsylvania,  and  the  think- 
ing public  have  been  awakened  to  the  serious  danger  to  the 
lives  and  health  of  the  community  if  the  antivivisectionist 
view  prevails;  for,  as  Mr.  Dickson  points  out,  not  only 
"must  all  further  experiment  be  stopped  and  future  re- 
search be  brought  to  an  end,  but  it  will  not  be  possible  to 
obtain  and  test  vaccine  for  protection  against  smallpox  by 
the  inoculation  of  calves,  or  the  antitoxins,  from  the  inocu- 
lation of  horses,  against  diphtheria,  lockjaw,  or  the  epi- 
demic form  of  cerebro-spinal  meningitis."  It  would  also 
prevent  the  inoculation  of  guinea-pigs  to  aid  us  in  diagnos- 
ing the  early  stages  of  tuberculosis;  in  testing  the  strength 
of  preparations  of  ergot  on  animals,  and  would  thus  endan- 
ger the  lives  of  many  women  in  cases  of  hemorrhage  in 
childbirth. 

What  the  organized  medical  profession  believe  is  shown, 
for  example,  in  the  following  quotations. 

In  1892,  the  British  Medical  Association,  numbering  over 
15,000  members  and  almost  all  of  the  leading  men  of  the  pro- 
fession in  Great  Britain,  unanimously  passed  the  following 
resolution:  — 

**  Resolved,  That  this  general  meeting  of  the  British  Medical 
Association  records  its  opinion  that  the  results  of  experiments  on 


s:vi  PREFACE 

living  animals  have  been  of  inestimable  service  to  man  and  to  the 
lower  animals,  and  that  the  continuance  and  extension  of  such 
investigations  is  essential  to  the  progress  of  knowledge,  the  reHef 
of  suffering,  and  the  saving  of  Ufe.'*  ^ 

The  recent  International  Medical  Congress  in  London, 
composed  of  the  most  distinguished  members  of  the  pro- 
fession from  every  civilized  country  in  the  world,  at  a 
general  meeting  August  12,  1913,  unanimously  approved 
the  following  resolution:  — 

That  this  Congress  records  its  conviction  that  experiments  on 
living  animals  have  proved  of  the  utmost  service  to  medicine  in 
the  past,  and  are  indispensable  to  its  future  progress.  That, 
accordingly,  while  strongly  deprecating  the  infliction  of  unneces- 
sary pain,  it  is  of  opinion,  alike  in  the  interests  of  man  and  of 
animals,  that  it  is  not  desirable  to  restrict  competent  persons  in 
the  performance  of  such  experiments.^ 

At  the  meeting  of  the  Federation  of  American  Societies 
for  Experimental  Biology  held  in  Philadelphia  on  Decem- 
ber 31,  1913,  the  following  declaration  was  unanimously 
adopted:^  — 

1.  We,  the  members  of  the  Federation  of  American  Societies  for 
Experimental  Biology,  —  comprising  the  American  Physiological 
Society,  the  American  Society  of  Biological  Chemists,  the  Ameri- 
can Society  for  Pharmacology  and  Experimental  Therapeutics, 
and  the  American  Society  for  Experimental  Pathology,  —  in 
convention  assembled,  hereby  express  our  accord  with  the  decla- 
ration of  the  recent  International  Medical  Congress  and  other 
authoritative  medical  organizations,  in  favor  of  the  scientific 
method  designated  properiy  animal  experimentation,  but  some- 
times vivisection. 

2.  We  point  to  the  remarkable  and  innumerable  achievements, 
by  means  of  animal  experimentation  in  the  past,  in  advancing 
the  knowledge  of  biological  laws  and  devising  methods  of  pro- 

1  British  Medical  Journal,  August  6,  1892,  p.  306. 

2  British  Medical  Journal,  1913,  vol.  ii,  p.  429. 
»  Science,  February  6,  1914,  p.  217. 


PREFACE  xvii 

cedure  for  the  cure  of  disease  and  for  the  prevention  of  suffering 
in  human  beings  and  lower  animals.  We  emphasize  the  necessity 
of  animal  experimentation  in  continuing  similar  beneficent  work 
in  the  future. 

3.  We  are  firmly  opposed  to  cruelty  to  animals.  We  heartily 
support  all  humane  efforts  to  prevent  the  wanton  infliction  of 
pain.  The  vast  majority  of  experiments  on  animals  need  not  be 
and,  in  fact,  are  not  accompanied  by  any  pain  whatsoever. 
Under  the  regulations  already  in  force,  which  reduce  discomfort 
to  the  least  possible  amount  and  which  require  the  decision  of 
doubtful  cases  by  the  responsible  laboratory  director,  the  per- 
formance of  those  rare  experiments  which  involve  pain  is,  we 
beheve,  justifiable. 

4.  We  regret  the  widespread  lack  of  information  regarding  the 
aims,  the  achievements,  and  procedures  of  animal  experimenta- 
tion. We  deplore  the  persistent  misrepresentation  of  these  aims, 
achievements,  and  procedures  by  those  who  are  opposed  to  this 
scientific  method.  We  protest  against  the  frequent  denuncia- 
tions of  self-sacrificing,  high-minded  men  of  science  who  are 
devoting  their  lives  to  the  welfare  of  mankind  in  efforts  to  solve 
the  compHcated  problems  of  Hving  beings  and  their  diseases. 

In  1908,  the  two  largest  scentific  bodies  of  the  United 
States,  the  American  Medical  Association^  and  the 
American  Association  for  the  Advancement  of  Science,^ 
unanimously  adopted  the  following  resolutions:^  — 

Whereas,  from  time  to  time,  attempts,  fostered  largely  by 
erroneous  statements  and  accusations  and  false  sentiment  and 
prejudice,  are  made  in  some  parts  of  this  country  to  enact  specific 
legislation,  prescribing  the  conditions  under  which  experiments 
on  animals  may  or  may  not  be  performed;  be  it 

A.  Resolved,  by  the  Association,  That  animal  experimentation 
has  been  of  incalculable  benefit  to  medical  science  and  art,  the 
progress  of  which  is  as  absolutely  dependent  on  experimental 
methods  as  are  all  the  physical  and  natural  sciences. 

1  Journal,  American  Medical  Association,  June  13,  1908,  p.  2001. 

2  Ihid.,  January  9,  1909,  pp.  144,  145. 

3  Very  slight  verbal  variations  exist  in  "B." 


xviii  PREFACE 

B.  Resolved,  That  no  abuse  of  the  practice  of  animal  experimen- 
tation in  this  country  has  been  shown  to  exist  to  warrant  specific 
legislation,  nor  is  there  any  probability  of  such  abuse  arising. 

C.  Resolved,  by  the  Association,  That  the  unrestricted  perform- 
ance by  proper  persons  of  scientific  experiments  on  living  ani- 
mals is  essential  to  the  maintenance  and  progress  of  medicine 
and  biology. 

These  resolutions  represent  the  collective  ojdnion  of  the 
medical  profession,  not  only  of  Great  Britain  and  America, 
but  of  the  whole  civilized  worid. 

Per  contra,  there  is  not,  so  far  as  I  know,  a  single  resolution 
of  any  scientific  body  expressing  the  opposite  opinion. 

In  addition  to  all  this  the  following  quotation  from  the 
unanimous  Report  of  the  English  Royal  Commission  on 
Vivisection,  composed  of  the  advocates  and  opponents  of 
animal  experimentation,  is  published  in  their  final  Report 
in  1912,  on  page  20. 

We  desire  to  state  that  the  harrowing  descriptions  and  illus- 
trations of  operations  inflicted  on  animals,  which  are  freely 
circulated  by  post,  advertisement,  or  otherwise,  are  in  many 
cases  calculated  to  mislead  the  pubHc,  so  far  as  they  suggest  that 
the  animals  in  question  were  not  under  an  anesthetic.  To  repre- 
sent that  animals  subject  to  experiments  in  this  country  are  wan- 
tonly tortured  would,  in  our  opinion,  be  absolutely  false. 

The  Bureau  on  Protection  of  Medical  Research,  ap- 
pointed by  the  Council  on  Health  and  Public  Instruction 
of  the  American  Medical  Association,  has  published  a 
series  of  twenty-six  pamphlets,  a  list  of  which  is  appended. 
The  pamphlets  in  this  series  set  forth  from  different  as- 
pects the  value  and  importance  of  experimental  research 
very  cleariy.   The  price  is  only  a  few  cents  each. 

I  beg  to  express  to  the  distinguished  President  Emeritus 
of  Harvard  University,  Dr.  Charies  W.  Eliot,  my  warm 
thanks  for  his  kindness  in  furnishing  the  Introductory 
Note.    His  indorsement  hall-marks  any  book. 


PREFACE  xix 

LIST  OF  PAMPHLETS  ISSUED  BY  THE  BUREAU  ON  PRO- 
TECTION OF  MEDICAL  RESEARCH  OF  THE  AMERICAN 
MEDICAL  ASSOCIATION 

Pamphlet  I.  —  Vaccination  and  its  Relation  to  Animal  Experimenta- 
tion, by  Dr.  J.  F.  Schamberg,  Philadelphia.    56  pages.    Illustrated. 

Pamphlet  II.  —  Animal  Experimentation  and  Tuberculosis,  by  Dr. 
E.  L.  Trudeau,  Saranac  Lake,  N.Y.     16  pages. 

Pamphlet  HI.  —  The  R6le  of  Animal  Experimentation  in  the  Diag- 
nosis of  Disease,  by  Dr.  M.  J.  Rosenau,  Washington,  D.C.    8  pages. 

Pamphlet  IV.  —  Animal  Experimentation  and  Cancer,  by  Dr.  James 
Ewing,  New  York.     12  pages. 

Pamphlet  V.  —  The  Ethics  of  Animal  Experimentation,  by  Professor 
J.  R.  Angell,  Chicago.    8  pages. 

Pamphlet  VI.  —  Animal  Experimentation:  The  Protection  it  Affords 
to  Animals  Themselves  and  its  Value  to  the  Live-Stock  Industry,  by  Dr. 
V.  A.  Moore,  Ithaca,  N.Y.     20  pages. 

Pamphlet  VII.  —  Rabies  and  its  Relation  to  Animal  Experimenta- 
tion, by  Dr.  L.  Frothingham,  Boston.     16  pages. 

Pamphlet  VIII.  —  Importance  of  Animal  Experimentation  in  the 
Development  of  Knowledge  of  Dysentery,  Cholera  and  Typhoid  Fever, 
by  Dr.  M.  W.  Richardson,  Boston.    8  pages. 

Pamphlet  IX.  —  Fruits  of  Medical  Research  with  Aid  of  Anesthesia 
and  Asepticism,  by  Dr.  Charles  W.  Eliot,  Boston.     16  pages. 

Pamphlet  X.  —  Animal  Experimentation  in  Relation  to  Our  Knowl- 
edge of  Secretions,  Especially  Internal  Secretions,  by  Dr.  S.  J.  Meltzer, 
New  York.    32  pages. 

Pamphlet  XL  —  Animal  Experimentation  and  Protozoan  Tropical 
Diseases,  by  Dr.  Harry  T.  Marshall,  Chariottesville,  Va.     20  pages. 

Pamphlet  XII.  —  Modern  Antiseptic  Surgery  and  the  R61e  of  Experi- 
ment in  its  Discovery  and  Development,  by  Dr.  W.  W.  Keen,  Phila- 
delphia.    20  pages. 

Pamphlet  XIII.  —  Animal  Experimentation  in  Relation  to  Practical 
Medical  Knowledge  of  the  Circulation,  by  Dr.  Joseph  Erianger,  Madison, 
Wis.     40  pages. 

Pamphlet  XIV.  —  What  Vivisection  has  Done  for  Humanity,  by 
Dr.  W.  W.  Keen,  Philadelphia.     16  pages. 

Pamphlet  XV.  —  The  Relation  of  Animal  Experimentation  to  Our 
Knowledge  of  Plague,  by  George  W.  McCoy,  San  Francisco.     12  pages. 

Pamphlet  XVL  —  Medical  Control  of  Vivisection,  by  Dr.  Walter  B. 
Cannon,  Boston.     8  pages. 

Pamphlet  XVII.  —  Immunology:  A  Medical  Science  Developed 
through  Animal  Experimentation,  by  Dr.  Frederick  P.  Gay,  Berkeley, 
Cal.     20  pages. 

Pamphlet  XVIII.  —  Obstetrics  and  Animal  Experimentation,  by 
Dr.  J.  Whitridge  Williams,  Baltimore.    36  pages. 


XX  PREFACE 

Pamphlet  XIX.  —  Some  Characteristics  of  Antivivisection  Litera- 
ture, by  Dr.  Walter  B.  Cannon,  Boston.     16  pages. 

Pamphlet  XX.  —  The  Value  of  Animal  Experimentation  as  Illus- 
trated by  Recent  Advances  in  the  Study  of  Syphilis,  by  Dr.  J.  W.  Church- 
man, Baltimore.     24  pages. 

Pamphlet  XXI.  —  Animal  Experimentation  and  Epidemic  Cerebro- 
spinal Meningitis,  by  Dr.  C.  H.  Dunn,  Boston.     28  pages. 

Pamphlet  XXII.  —  Animal  Experimentation  and  Diphtheria,  by 
Dr.  W.  H.  Park,  New  York.     19  pages. 

Pamphlet  XXIII.  —  Animal  Experimentation  and  its  Benefits  to 
Mankind,  by  Dr.  Walter  B.  Cannon,  Boston.     24  pages. 

Pamphlet  XXIV.  —  The  Influence  of  Antivivisection  on  Character, 
by  Dr.  W.  W.  Keen,  Philadelphia.     43  pages. 

Pamphlet  XXV.  —  Antivivisection  Legislation:  Its  History,  Aims, 
and  Menace.     By  Dr.  W.  B.  Cannon,  Boston.     11  pages. 

Pamphlet  XXVI.  —  The  Charge  of  "Human  Vivisection"  as  Pre- 
sented in  Antivivisection  Literature,  by  Richard  M.  Pearce,  M.D., 
Philadelphia.    32  pages. 

Prices 
Pamphlets  I,  XIII  and  XXIV:  Other  pamphlets  of  the  series: 


1  Copy $.08 

5  Copies 35 

10  Copies 65 

25  Copies 1.25 


1  Copy $.04 

5  Copies 15 

10  Copies 25 

25  Copies 60 


Orders  should  be  sent  to  the  American  Medical  Association,  535 
N.  Dearborn  St.,  Chicago,  Illinois. 


CONTENTS 

Introduction xxiii 

OuB  Recent  Debts  to  Vivisection 1 

Recent  Progress  in  Surgery 22 

Vivisection  and  Brain-Surgery 45 

The  Progress  of  Surgery  as  Influenced  by  Vivisection    72 

Misstatements  of  Antivivisectionists 110 

Misstatements  of  the  Antivivisectionists  again     .    .  135 

Midshipman  Aiken  and  Vivisection 146 

Recent  Surgical  Progress  a  Result  chiefly  of  Experi- 
mental Research 151 

The  New  Surgery 171 

Modern  Antiseptic  Surgery  and  the  Role  of  Experi- 
ment in  its  Discovery  and  Development    ....  199 
What  Vivisection  has  done  for  Humanity     ....  220 
The  Influence  op  Antivivisection  on  Character  .    .  234 
The  Antivivisection    Exhibition    in    Philadelphia 

in  1914 286 

Selected  Quotations 291 

A  Letter  to  "Life" 296 

Index 299 


INTRODUCTION 

Dr.  Keen  describes  in  this  book,  in  a  very  interesting 
and  convincing  manner,  the  new  sui^ery  of  the  last  forty 
years  and  its  extraordinarily  beneficent  results.  He  shows 
that  the  progress  of  surgery  has  taken  effect  in  all  parts  of 
the  human  body,  including  the  brain,  spine,  chest,  stomach, 
intestines,  liver,  gall  bladder,  appendix,  pancreas,  spleen, 
and  kidneys,  and  the  arteries,  veins,  and  nerves;  that  many 
operations  which  were  impossible,  or  had  a  high  mortality, 
before  aseptic  surgery  was  invented,  have  become  not  only 
possible  but  safe;  and  that  innumerable  lives  have  been 
saved,  and  are  continually  being  saved,  by  operations  new 
within  forty  years.  He  also  demonstrates  that  the  new 
surgery  has  reduced  very  much  the  period  required  for  re- 
covery, as  well  as  the  death-rate,  after  a  large  variety  of 
operations,  —  such  as  those  for  compound  fractures, 
ovariotomy,  hernia,  goiter,  and  the  removal  of  cancers  and 
tumors,  —  and  that  the  proportion  of  complete  and  rapid 
cures  after  operation  has  been  greatly  increased.  He  points 
out  that  lockjaw  has  been  almost  abolished;  that  the  direct 
transfusion  of  blood  has  been  achieved;  that  the  mortality 
from  diphtheria  and  cerebro-spinal  meningitis  —  two 
formidable  diseases  now  successfully  treated  by  antitoxins 
—  has  been  greatly  reduced;  that  yellow  fever  has  been 
abolished  as  a  destructive  epidemic;  and  that  child-birth 
fever,  formerly  very  destructive,  has  become  rare. 

The  new  surgery  has  been  made  possible  by  the  combi- 
nation of  anesthesia  and  asepticism;  but  asepticism  owes 
to  animal  experimentation,  guided  and  furthered  by  the 
new  science  and  art  of  bacteriology,  its  origin  and  its  suc- 
cessful applications.  Through  animal  experimentation, 
also,  numerous  valuable  drugs  have  been  tested  before  being 


xxiv  INTRODUCTION 

used  on  man;  and  the  beneficent  use  of  each  has  been 
defined. 

The  immense  benefits  which  modem  surgery  and  serum- 
therapy  have  conferred  on  mankind  are  therefore  due  to 
animal  experimentation. 

Since  experiments  on  the  living  human  being  are  seldom 
possible,  or  indeed  justifiable,  except  by  request  of  the 
patient  in  desperate  cases,  and  since  all  scientific  knowledge 
comes  by  the  way  of  experiment,  the  progress  of  medicine 
and  surgery  was  very  slow,  so  long  as  the  only  means  of 
advancing  them  was  by  the  study  of  sick  or  injured  human 
bodies  and  the  post-mortem  examinations.  Animal  experi- 
mentation has  already  made  progress  rapid,  and  will  be 
even  more  fruitful  in  the  future. 

In  the  manufacture  of  the  serums  now  used  in  the  treat- 
ment of  diseases,  as  in  diphtheria,  tetanus,  and  cerebro- 
spinal meningitis,  the  serum  has  to  be  tested  on  animals 
before  it  is  used  on  human  beings;  and  therefore  some  rab- 
bits, guinea-pigs,  or  other  small  animals  are  sacrificed 
during  the  process  of  manufacturing  serums  of  good  qual- 
ity. In  learning  how  to  sew  together  two  bowel  ends  or  the 
two  ends  of  an  artery,  vein,  or  nerve  which  has  been 
severed,  a  few  dogs  and  cats  were  sacrificed.  In  learning 
the  locahzation  of  function  in  the  different  parts  of  the 
human  brain,  many  animals  had  to  be  sacrificed  before  the 
human  skull  could  safely  be  entered  at  the  right  spot  for 
relieving  a  hemorrhage,  or  removing  a  tumor. 

Through  these  sacrifices  of  animal  life  or  happiness, 
always  made  as  painless  as  possible,  surgeons  and  physi- 
cians have  been  able  to  save  innumerable  human  lives 
which,  without  the  help  of  the  new  surgery  and  therapy, 
would  have  been  lost,  and  to  relieve  or  remedy  innumerable 
cases  of  human  suffering  and  injury.  Is  it  justifiable  to  use 
animals  in  this  way? 

The  human  race  daily  devours  animals,  large  and  small, 
by  the  million,  cuts  off  animal  fife  by  eating  innumerable 


INTRODUCTION  xxv 

eggs  from  which  animals  would  develop,  makes  the  animals 
capable  of  domestication  work  for  them  in  multifarious 
ways,  and  thereby  deprives  them  of  their  liberty  and  of 
their  natural  joys.  The  number  of  animals  used  for  the 
benefit  of  the  human  race  in  making  possible  the  recent 
advances  of  surgery  and  medicine  is  insignificant,  indeed 
infinitesimal,  compared  with  the  number  used  for  human 
food  and  human  service;  but  the  benefits  to  mankind  which 
result  from  animal  experimentation  are  immeasurable  in 
quantity,  and  very  precious  in  quality. 

How  many  rabbits  or  guinea-pigs  is  it  justifiable  to 
incommode  or  kill,  in  order  to  save  the  life  of  a  child 
attacked  by  diphtheria?  How  many  monkeys  would  a 
competent  experimenter  be  justified  in  sacrificing,  in  order 
to  find  a  sure  treatment  for  infantile  paralysis.^  How  many 
rats  is  it  justifiable  for  men  to  kill,  in  order  to  protect  a 
city  from  an  epidemic  of  bubonic  plague?  Dr.  Keen  sug- 
gests at  many  points  the  reasonable  answer  to  all  such 
questions  as  these. 

One  third  of  the  book  is  devoted  to  the  exposition  of  the 
unreasonableness,  inaccuracy,  and  indifference  to  truth 
and  justice  manifested  by  the  antivivisectionists  in  select- 
ing the  premises  of  their  argument  against  animal  experi- 
mentation. He  points  out  over  and  over  again  that  the 
antivivisectionists  would  be  the  cruel  people,  if  they  could 
have  their  way,  cruel  to  their  own  kind;  and  that  the  sur- 
geons and  physiologists,  and  the  men  who  devote  them- 
selves to  medical  and  surgical  research  are  carrying  on  the 
most  humane  work  now  done  in  the  world.  Dr.  Keen  thus 
sets  before  his  readers  in  a  striking  way  the  evil  conse- 
quences which  may  flow  from  the  morbid  perversion  of  a 
humane,  kindly,  or  altruistic  sentiment.  In  this  case,  the 
common  sense  of  mankind  ought  to  be  able  to  prevent  the 
victims  of  a  perverted  sentiment  from  doing  serious  harm 
to  the  human  race. 

One  must  always  remember  that  when  by  a  course  of 


xxvi  INTRODUCTION 

experiments  on  a  few  animals  a  scientific  discoverer  arrives 
at  knowledge  of  the  mode  of  transmission  of  a  dangerous 
pestilence,  at  a  new  means  of  preventing  the  spread  of  a 
disease,  or  at  a  new  medical  or  surgical  treatment  of  a 
disease  or  a  wound,  the  benefits  of  the  discovery  go  on 
generation  after  generation,  multiplying  as  they  go.  There 
lies  an  immense  hope  for  the  future !  To  propose  that  such 
a  hope  shall  be  blighted  by  stopping  animal  experimenta- 
tion argues  an  extraordinary  infatuation  in  the  proposer. 
Dr.  Keen  is  a  competent  witness  to  the  progress  of  sur- 
gery during  the  past  fifty  years.  His  surgical  career  began 
in  1862,  when  aseptic  surgery  was  unknown;  so  that  he  has 
personally  seen  the  whole  development  of  modern  surgery, 
and  indeed  has  actively  participated  in  its  achievements. 
His  career  proves  him  to  be  a  clear-sighted,  alert,  and 
dihgent  student,  and  a  wise  and  skillful  practitioner.  He 
is  also,  like  most  good  surgeons,  a  humane  and  sympathetic 
man. 

Charles  W.  Eliot. 

7  October,  1914. 


ANIMAL  EXPERIMENTATION 
AND  MEDICAL  PROGRESS 


ANIMAL  EXPERIMENTATION  AND 
MEDICAL  PROGRESS 

OUR  RECENT  DEBTS  TO  VIVISECTION^ 

It  is  to  one  of  the  medical  issues  of  the  day  to  which  I  pur- 
pose to  direct  your  attention  at  present,  —  one  as  to  which, 
especially  among  women,  intense  feeling  has  been  aroused, 

—  namely,  the  question  of  experiments  upon  animals. 
Epithets  and  invective  have  been  freely  used,  but,  as 

befits  the  audience  and  the  occasion,  I  shall  endeavor  to 
approach  it  in  a  perfectly  calm  and  fair  spirit,  seeking  to 
lay  before  you  only  one  aspect  of  a  many-sided  question, 

—  namely,  the  actual  practical  benefits  it  has  conferred 
upon  man  and  animals,  —  a  fact  that  is  constantly  denied, 
but  which  medical  evidence  proves  to  be  incontestable. 

I  shall  not  consider  the  important  older  discoveries  it 
has  given  us,  but  only  those  since  1850,  almost  all  of  which 
are  within  my  own  personal  recollection.  Even  of  these 
I  must  omit  nearly  all  of  its  contributions  to  physiology  and 
to  pathology,  though  so  much  of  our  practice  is  based  upon 
these,  and  confine  myself  to  the  advances  it  has  enabled  us 
to  make  in  medical  and  surgical  practice.  I  shall  endeavor 
to  state  its  claims  with  moderation,  for  an  extravagant 
claim  always  produces  a  revulsion  against  the  claimant, 
and  is  as  unwise  as  it  is  unscientific. 

Again  it  must  be  borne  in  mind  that,  as  in  nearly  every 
other  advance  in  civiKzation  and  in  society,  so  in  medicine, 
causes  are  rarely  single,  but  generally  multiple  and  inter- 

^  The  address  to  the  graduates  at  the  Thirty-third  Commencement  of 
the  Woman's  Medical  College  of  Pennsylvania,  March  11,  1885.  Re- 
printed by  permission  from  the  Popular  Science  Monthly  for  May,  1885. 


2  ANIMAL  EXPERIMENTATION 

woven.  While  vivisection  has  been  a  most  potent  factor 
in  medical  progress,  it  is  only  one  of  several  factors,  the 
disentanglement  of  which  and  the  exact  balancing  of  how 
much  is  due  to  this  or  to  that  are  often  diflficult  and  some- 
times impossible.  Let  me  add  one  word  more.  All  that  I 
may  say  is  purely  upon  my  own  responsibility.  I  commit 
the  opinion  of  no  one  else  to  any  view  or  any  statement  of 
fact. 

Medicine  in  the  future  must  either  grow  worse,  stand 
still,  or  grow  better. 

To  grow  worse,  we  must  forget  our  present  knowledge 
' —  happily,  an  inconceivable  idea. 

To  stand  still,  we  must  accept  our  present  knowledge 
as  a  finality,  complacently  pursuing  the  well-worn  paths; 
neither  hoping  nor  trying  for  anything  better  —  happily, 
agaiuj  an  impossibility. 

To  grow  better  we  must  try  new  methods,  give  new 
drugs,  perform  new  operations,  or  perform  old  ones  in  new 
ways;  that  is  to  say,  we  must  make  experiments.  To  these 
experiments  there  must  be  a  beginning:  they  must  be  tried 
first  on  some  living  body,  for  it  is  often  forgotten  that  the 
dead  body  can  only  teach  manual  dexterity.  They  must 
then  be  tried  either  on  an  animal  or  on  you.  Which  shall 
it  be?  In  many  cases,  of  course,  which  involve  little  or  no 
risk  to  life  or  health,  it  is  perfectly  legitimate  to  test  prob- 
able improvements  on  man  first,  although  one  of  the  grav- 
est and  most  frequent  charges  made  against  us  doctors  is 
that  we  are  experimenting  upon  our  patients. 

But  in  many  cases  they  involve  great  risk  to  fife  or  health. 
Here  they  cannot,  nay,  they  must  not,  be  tested  first  upon 
man.  Must  we,  then,  absolutely  forego  them,  no  matter 
how  much  of  promise  for  life  and  health  and  happiness  they 
possess?  If  not,  the  only  alternative  we  have  is  to  try  them 
on  the  lower  animals,  and  we  would  be  most  unwise  — 
nay,  more,  we  would  be  cruel,  cruel  both  to  man  and  to 


AND  MEDICAL  PROGRESS  3 

animals  —  if  we  refused  to  pain  or  even  to  slay  a  few  ani- 
mals, that  thousands,  both  of  men  and  of  animals,  might  live. 
Who  would  think  it  right  to  put  a  few  drops  of  the  hydro- 
chlorate  of  cocain  (a  year  ago  almost  an  unknown  drug) 
into  the  eye  of  a  man,  not  knowing  what  frightful  inflam- 
mation or  even  loss  of  sight  might  follow?  Had  one  dared 
to  do  it,  and  had  the  result  been  disastrous,  would  not  the 
law  have  held  him  guilty  and  punished  him  severely,  and 
all  of  us  have  said  Amen?  But  so  did  Christison  with  Cala- 
bar bean,  and  well-nigh  lost  his  own  life.  So  did  Toynbee 
with  prussic  acid  on  himself,  and  was  found  dead  in  his 
laboratory.^  Accordingly,  KoUer,  of  Vienna,  properly  and 
wisely  tried  cocain  first  on  animals,^  and  then,  finding  its 
beneficial  effects,  tried  it  upon  man  with  like  results,  and 
one  of  the  most  remarkable  drugs  of  modern  times  was  thus 
made  available.  We  are  only  on  the  threshold  of  its  use- 
fulness. It  has  been  used  in  the  eye,  the  ear,  the  nose, 
the  mouth,  the  larynx,  and  all  other  mucous  membranes, 
in  the  removal  of  tumors,  and  as  an  internal  medicine. 
When  its  physiological  action  has  been  still  more  thor- 
oughly and  systematically  investigated,  its  poisonous  dose 
ascertained,  when  we  know  how  it  works,  what  its  effects 
are  upon  the  blood-pressure,  the  heart,  the  nerves,  the 
blood-vessels,  —  effects  that  cannot  be  accurately  studied 
upon  man,  —  its  usefulness  may  be  increased  to  an  extent 
as  yet  but  little  dreamed  of.  Should  it  only  soothe  the  last 
painful  hours  of  our  great  hero.  General  Grant,  a  nation 
will  bless  it  and  the  experiments  which  gave  it  effect.  More- 
over, had  the  experiments  of  Dr.  Isaac  Ott,  of  Easton,^  on 
this  very  drug,  borne  their  due  fruit,  America  would  have 
had  the  honor  and  the  human  race  the  benefits  of  cocain 
ten  years  ago  —  ten  years  of  needless  suffering! 

1  See  also  Sir  Lyon  Play  fair's  statement  on  p.  258. 

2  Archives  of  Ophthalmology,  September  and  December,  1884,  p.  402; 
New  York,  Putnam's. 

3  Ott,  Cocain,  Veratrine,  and  Gelsemium,  Philadelphia,  1874. 


4  ANIMAL  EXPERIMENTATION 

This  is  but  one  illustration  of  the  value  of  experiments 
upon  animals  in  the  realm  of  new  drugs.  In  fact,  substitute 
for  cocain  other  drugs,  or  new  operations,  or  new  methods 
of  medical  treatment,  and  the  argument  repeats  itself  for 
each.  Within  the  last  thirty  years  a  multitude  of  new  drugs 
have  thus  been  discovered,  and  their  effects  have  been  either 
first  tested  upon  animals,  or  their  properties  studied  ex- 
haustively in  a  manner  impracticable  upon  man.  I  will 
only  enumerate  some  of  them,  since  time  will  not  allow  me 
to  enter  upon  each  in  detail.  Thus  have  been  introduced 
lily-of-the-valley  in  heart  disease,  yellow  jasmine  in  dis- 
eases of  the  heart  and  nervous  system,  paraldehyde  and 
chloral  hydrate,  so  valuable  for  sleep,  caffein  for  headache, 
eucalyptus  as  an  antiseptic  and  in  medicine,  nitroglycerin 
for  nervous  maladies,  Calabar  bean  for  disease  of  the  eye 
and  nervous  system,  naphthalin  and  iodoform  in  surgery, 
quebracho  as  an  antispasmodic,  antipyrin  and  kairin  in 
fever,  jaborandi  in  dropsy,  salicylic  acid  in  rheumatism, 
nitrite  of  amyl  in  epilepsy  and  intermittent  fever,  jequirity 
in  ophthalmic  surgery,  piscidia  as  a  substitute  for  opium, 
the  hypodermatic  method  of  using  drugs,  and  so  on  through 
a  long  list.  And,  as  to  the  old  drugs,  it  may  be  truly  said 
that  we  have  little  exact  —  that  is,  scientific  —  knowledge 
of  any  one  except  through  experiments  upon  animals.^ 

^  For  three  hundred  years  digitalis,  for  instance,  has  been  given  as  a 
depressant  of  the  heart,  and,  when  a  student,  I  was  taught  to  avoid  it 
carefully  when  the  heart  was  weak.  But  the  accurate  experiments  of 
Bernard  and  others  have  shown  that  it  is,  on  the  contrary,  actually  a 
heart  tonic  and  stimulant.  So  long  as  I  live  I  shall  never  forget  the  intense 
joy  of  myself  and  the  agonized  parents,  when  one  bright  young  life  was 
brought  back  from  the  very  grave,  some  five  years  ago,  by  the  knowledge 
of  this  fact,  and  this  is  but  one  of  many  such  cases.  Thus  have  the 
action  and  dangers  of  our  common  anesthetics  been  positively  and  accu- 
rately ascertained;  thus  the  action  of  ergot  on  the  blood-vessels,  explain- 
ing alike  its  danger  as  an  article  of  food  and  its  wonderful  use  in  certain 
tumors  of  the  uterus  and  diseases  of  the  nervous  centers;  thus,  too,  every 
one  who  gives  opium  in  its  various  forms  is  a  debtor  to  Bernard,  and 
every  one  who  gives  strychnin  a  disciple  of  Magendie. 

"As  ergot  is  a  drug  that  varies  greatly  in  physiological  activity  in  its 


I 


AND  MEDICAL  PROGRESS  5 

Let  us  now  see  something  of  what  America  has  done  in 
advancing  practical  medicine  by  vivisection.  In  passing,  I 
may  say  that  the  assertion  that  America  has  contributed 
but  Httle,  so  far  from  being  an  argument  for  the  restriction 
of  vivisection,  is  a  strong  argument  for  its  further  cultiva- 
tion, in  order  that  greater  good  may  result  from  remark- 
able discoveries  here,  equal  to  those  that  I  shall  show  have 
been  made  in  Europe. 

Wounds  of  the  abdomen,  especially  gunshot  wounds,  are 
among  the  most  fatal  injuries  known  to  surgery.  A  small, 
innocent-looking,  external  pistol  wound  may  cover  multiple 
and  almost  inevitably  fatal  perforations  of  the  abdominal 
viscera.  The  recoveries  from  3717  such  wounds  during 
the  late  Civil  War  only  numbered  444,  and  of  those  with 
escape  of  the  intestinal  contents  the  recoveries,  says  Otis, 
may  be  counted  on  one's  fingers.  The  prevailing  treatment 
as  laid  down  in  our  textbooks  has  been  purely  conserva- 
tive, treating  symptoms  as  they  arise.  The  brilliant  results 
achieved  in  other  abdominal  operations  have  led  a  few  bold 
spirits,  such  as  our  own  Sims,  Gross,  Otis,  McGuire,  and 
others,  to  advocate  the  opening  of  the  abdomen  and  the 
repair  of  the  injuries  found. 

In  May  of  last  year,  Parkes,  of  Chicago,  reported  to  the 
American  Medical  Association  ^  a  series  of  systematic  ex- 
periments on  thirty-seven  dogs,  that  were  etherized,  then 
shot,  the  abdomen  opened,  and  the  wounds  of  the  intestines, 

crude  state  and  cannot  be  chemically  assayed  with  advantage,  the  phy- 
sician should  always  use  a  preparation  which  has  been  physiologically 
tested  by  the  manufacturer  before  it  is  placed  on  the  market."  (Hare's 
Practical  Therapeutics,  11th  ed.,  1905,  p.  236.) 

The  physiological  test  of  ergot  is  by  giving  it  to  animals  and  observ- 
ing the  effects  on  the  caliber  of  the  small  blood-vessels.  Unless  so  physio- 
logically tested,  the  physician,  surgeon,  and  especially  the  obstetrician, 
may  be  ignorantly  using  a  wholly  inert  preparation,  thus  seriously  en- 
dangering human  life. 

1  Medical  News,  May  17, 1884.  I  shall  refer  readers  frequently  to  this 
ioumal,  as  it  is  often  more  accessible  than  foreign  journals,  and  it  will 
refer  them  to  the  original  papers. 


6  ANIMAL  EXPERIMENTATION 

arteries,  mesentery,  etc.,  treated  by  appropriate  surgical 
methods.  The  results  confirmed  the  behef  awakened  by 
eariier  experiments  and  observations  that  surgery  could 
grapple  successfully  with  multiple  and  formidable  wounds, 
by  sewing  them  up  in  various  ways,  or  even  by  removing  a 
piece  of  the  bowel  and  uniting  the  cut  ends.  Hard  upon  the 
heels  of  this  important  paper,  and  largely  as  its  result,  comes 
a  striking  improvement  in  practice.  And  remember  that 
this  is  only  the  first  fruit  of  a  rich  harvest  for  all  future  time, 
in  all  countries,  in  peace  and  in  war. 

November  2,  of  last  year,  a  man  was  brought  to  the 
Chambers  Street  Hospital,  in  New  York,  with  a  pistol- 
shot  wound  in  the  abdomen.  Under  careful  antiseptic 
precautions,  and  following  the  indications  of  Parkes,  the 
abdomen  was  opened  by  Dr.  BuU,^  coil  after  coil  of  the  in- 
testines was  drawn  out,  the  bullet  was  found  and  removed, 
and  seven  wounds  of  the  intestines  were  successfully  dis- 
covered and  properly  treated,  and  the  patient  made  an 
uninterrupted  recovery.  A  recovery,  after  so  many  wounds, 
any  one  of  which  would  necessarily  have  been  fatal  under 
the  old  methods  of  treatment,  shows  that  we  have  now 
entered  upon  a  proper  and  successful  method  of  treatment 
for  such  frightful  accidents. ^ 

This  is  but  one  of  the  remarkable  achievements  of  late 
years  in  abdominal  surgery.  The  spleen  has  been  removed, 
part  of  the  stomach  has  been  cut  out  for  cancer,^  part  of  the 
bladder  ^  has  been  dissected  away,  the  entire  gall-bladder 
has  been  removed,  and  several  inches  of  the  intestine  have 
been  cut  out,^  all  with  the  most  remarkable  success.  To  all 

1  Medical  News,  February  14,  1885. 

2  Since  1885  hundreds  of  such  wounds  have  been  successfully  treated 
and  recovery  has  followed  after  as  many  as  nineteen  wounds  of  the  bowels. 
(1914.) 

^  Since  1885  the  entire  stomach  has  been  repeatedly  removed.  (1914.) 
*  Since  then  the  entire  bladder  has  been  repeatedly  removed.  (1914.) 
^  Much  larger  portions  have  been  removed  since  then,  even  as  much 
as  eight  feet  eight  inches,  with  success.   (1914.) 


AND  MEDICAL  PROGRESS  7 

of  these,  experiments  upon  animals  have  either  led  the  way 
or  have  taught  us  better  methods.  To  recite  each  in 
detail  would  occupy  too  much  time,  but  one  illustration  I 
must  not  omit,  for  the  improvement  produced  by  it  and 
other  experiments,  affects  every  abdominal  operation. 
When  I  was  a  student,  the  peritoneum  was  avoided  by  knife 
and  needle  wherever  possible.  After  the  death  of  his  fourth 
case  of  ovariotomy,  Mr.  (now  Sir  Spencer)  Wells,  ^  in  making 
the  post-mortem,  was  led  to  believe  that  the  then  received 
treatment  of  the  peritoneum  was  incorrect,  and  that  he 
ought  to  bring  its  surfaces  in  contact  in  order  to  obtain 
secure  union.  Accordingly,  instead  of  testing  his  ideas 
upon  women,  he  experimented  upon  a  few  dogs,  and  found 
that  his  suspicions  were  correct.  Since  then  it  has  been  ac- 
cepted as  a  cardinal  point  in  all  abdominal  operations. 
Following  this  came  improvements  in  the  ligatures  used,  in 
the  method  of  treating  the  pedicle,  in  the  use  of  anti- 
septics, etc.,  all  more  or  less  the  result  of  experiments  upon 
animals,  and  what  are  the  results?  Taking  successive  hun- 
dreds of  cases.  Sir  Spencer  Wells's  percentage  of  mortality 
has  decreased  steadily  from  thirty-four  per  cent  to  eleven 
per  cent. 

Since  then,  others  have  reduced  the  percentage  of  deaths 
after  ovariotomy  to  three  in  the  hundred;  and  Martin,  of 
Berlin,  has  lost  but  one  patient  from  blood-poisoning  in  his 
last  one  hundred  and  thirty  cases. 

It  cannot  be  claimed,  of  course,  as  to  all  this  wonderful 
history  of  abdominal  surgery  —  and  remember  that  in 
1862,  when  I  was  a  medical  student,  I  heard  ovariotomists 
denounced  from  a  professor's  chair  as  murderers!  —  that 
experiments  upon  animals  have  done  the  whole  work.  No 
one  man,  no  one  series  of  experiments  has  sufficed,  and 
experiment  alone  would  not  have  done  it.  But  had  such  ex- 
periments not  been  made  on  animals,  as  to  the  peritoneum, 
the  pedicle,  the  sutures,  the  ligatures,  etc.,  we  should  be  far 
*  Wells,  Ovarian  and  Uterine  Tumors,  1882,  p.  197. 


8  ANIMAL  EXPERIMENTATION 

behind  where  we  now  are,  and  still  be  ignorantly  sacrificing 
human  life  and  causing  human  suffering. 

But  to  return  to  America.  The  first  condition  to  success- 
ful treatment  is  an  accurate  knowledge  of  what  any  disease 
is  —  its  cause  and  its  course;  then  we  may  guide  it,  and  in 
due  time,  it  may  be,  cure  it. 

Before  Dr.  H.  C.  Wood's  ^  accurate  experiments  on  the 
effects  of  heat  on  animals,  the  nature  and  effects  of  sun- 
stroke were  almost  matters  of  mere  conjecture.  Every  one 
had  his  own  theory,  and  the  treatment  was  equally  varied. 
Even  the  heat-effects  of  fever  itself  —  the  commonest  of 
all  symptoms  of  disease  —  were  ill  understood.  Wood  ex- 
posed animals  to  temperatures  of  120°  to  130°  F.  and  stud- 
ied the  effects.  These  experiments  have  often  been  alluded 
to  as  "baking  animals  alive."  You  will  note  that  the  heat 
was  no  greater  than  that  to  which  laborers  are  frequently 
exposed  in  our  hot  summer  days,  when  working  in  the  sun 
or  in  many  industrial  works.  His  experiments  showed  that 
the  effects  of  sunstroke  —  or,  as  he  happily  termed  it, 
thermic  or  heat  fever,  a  scientific  name  now  widely  adopted 
—  were  solely  due  to  the  heat,  death  following  from  coagu- 
lation of  the  muscular  structure  of  the  heart,  or  by  its 
effects  on  the  brain.  They  explained  also  many  of  the 
phenomena  of  ordinary  fever  as  the  result  of  heat  alone. 
They  have  established  the  rational  and  now  generally 
adopted  treatment  of  sunstroke  by  reduction  of  the  body- 
temperature;  and  the  same  method  is  now  beginning  to  be 
appreciated  and  employed  in  ordinary  fever. ^ 

The  same  observer,  with  Dr.  Formad,  has  made  impor- 
tant experiments  on  the  nature  of  diphtheria,  and  when  we 
learn,  as  we  probably  soon  shall,  how  to  deal  with  the 

1  Wood,  Thermic  Fever  or  Sunstroke,  Philadelphia,  1872. 

^  Eighteen  out  of  Wood's  experiments  were  on  the  general  effects  of 
heat,  as  above  alluded  to.  In  six  others  the  local  effects  of  heat  (135°  to 
190°  F.)  on  the  brain,  and  in  four  others  the  local  effects  (up  to  140°  F.) 
on  the  nerves  were  studied  and  gave  most  valuable  results,  entirely  and 
evidently  unattainable  on  man. 


( 


I 


AND  MEDICAL  PROGRESS 


microscopical  forms  of  life  which  seem  to  be  its  cause,  it 
will  not  be  too  much  to  hope  that  we  may  be  able  to  cope 
far  more  successfully  with  a  disease  now  desolating  so 
many  homes.  ^ 

In  India  alone  twenty  thousand  human  beings  die  annu- 
ally from  snake-bite,  2  and  as  yet  no  antidote  has  been  dis- 
covered. How  can  we  search  intelligently  for  an  antidote 
until  we  know  accurately  the  eflFects  of  the  poison?  This 
cannot  be  studied  on  man;  we  must  resort  to  animals,  or 
else  let  the  holocaust  go  on.  Accordingly,  Dr.  (now  Sir) 
Lauder  Brimton  began  such  a  series  of  experiments  in 
London,  but  was  stopped  by  the  stringent  antivivisection 
laws  there  in  force.  But  Drs.  Weir  Mitchell  and  Reichert,' 
in  this  city,  have  recently  undertaken  experiments  on 
cobra  and  rattlesnake  venom,  the  cobra-poison  being  fur- 
nished, be  it  observed,  by  the  British  Government,  whose 
own  laws  have  prevented  investigations  for  the  benefit  of 
its  own  subjects !  The  results  are  as  yet  only  partly  made 
known,  but  they  have  been  brilliantly  successful  in  showing 
that  there  are  two  poisons  in  such  venom,  each  of  which 
has  been  isolated  and  its  effects  studied.  The  first  step  has 
been  taken  —  the  poison  is  known.  Who  will  raise  a  finger 
to  stop  progress  toward  the  second  —  the  antidote?* 
Can  the  sacrifice  of  a  few  scores  of  animals  each  year  in 
such  research  weigh  for  a  moment  against  the  continuous 
annual  sacrifice  of  twenty  thousand  human  beings  ?  ^ 

^  The  remarkable  results  in  lessening  the  mortality  from  diphtheria 
by  the  use  of  the  antitoxin  discovered  since  this  address  was  first  pub- 
lished are  now  universally  known.  Thousands  of  human  lives,  especially 
of  children,  are  saved  annually  in  this  country  alone.   (1914.) 

2  Fayrer,  Thanatophidia  of  India,  p.  32. 

8  Medical  News,  April  28,  1883. 

*  Since  then  Calmette  and  Noguchi  have  both  announced  an  anti- 
venene  or  antidote  to  the  venom  of  snakes,  but  they  still  leave  much  to  be 
desired.   (1914.) 

^  I  am  permitted  by  Rev.  R.  M.  Luther,  of  this  city,  to  state  the  follow- 
ing fact  in  illustration  of  the  practical  value  of  vivisection  in  snake-bite: 
When  a  missionary  in  Burmah,  he  and  his  brother-in-law.  Rev.  Mr.  Vinton 
(two  missionary  vivisectionists!),  made  a  number  of  experiments  to  dis- 


k 


10  ANIMAL  EXPERIMENTATION 

The  modem  history  of  anesthetics  is  also  of  interest.  To 
say  nothing  of  ether  and  chloroform,  whose  safer  use  Bert 
has  investigated  in  France,  nor  of  cocain,  to  which  I  have 
already  alluded,  let  us  see  what  experiments  on  animals 
have  shown  us  as  to  bromid  of  ethyl  —  an  anesthetic  lately 
revived  in  surgery.  Its  revival  has  quickly  been  followed 
by  its  abandonment  on  account  of  the  frequent  sacrifice  of 
human  life  —  that  is  to  say,  experiments  on  human  beings 
have  proved  it  to  be  deadly.  Now,  Dr.  H.  C.  Wood,^  soon 
after  its  reintroduction,  made  a  study  of  its  effects  on 
animals,  and  showed  its  physiological  dangers.  Had  his 
warnings  been  heeded,  not  a  few  human  lives  would  have 
been  saved. 

The  ideal  anesthetic,  that  will  abolish  pain  without 
abolishing  consciousness,  and  do  so  without  danger,  is 
yet  to  be  found.  Cocain  is  our  nearest  approach  to  it. 
Now,  in  all  fairness  and  common  sense,  would  it  be  real 
kindness  or  real  cruelty  to  obstruct  the  search  for  such  an 
anesthetic  —  a  search  which  will  surely  be  rewarded  by 
success,  but  which,  if  not  carried  on  by  experiments  on 
animals,  must  be  tried  by  deadly  experiments  upon  man, 
or  else  be  entirely  given  up? 

In  1869  I  was  called  to  see  a  man  suffering  to  the  last 
degree  from  an  abscess  in  the  loin.  I  recognized  the  fact 
that  it  arose  from  the  kidney,  but  I  was  powerless.  All 
that  I  could  do  was  to  mitigate  his  pitiless  sufferings  and 
that,  alas!  but  little,  till  death  came  to  his  relief,  after 
nearly  a  year  of  untold  agony.  I  have  never  forgotten  his 

cover  an  antidote  to  the  poison  of  the  "brown  viper"  —  a  snake  but  little 
less  venomous  than  the  cobra.  They  found  a  substance  which  is  an  anti- 
dote in  about  sixty  per  cent  of  the  cases  if  applied  at  once.  Thah  Mway, 
one  of  their  native  preachers,  when  bitten  by  the  brown  viper,  had  some 
of  this  antidote  with  him,  and  by  its  use  his  life  was  saved  when  on  the 
verge  of  death.  This  one  life  saved,  it  is  estimated,  has  been  the  means 
of  leading  two  thousand  Karens  to  embrace  Christianity.  Was  not  this 
one  life  worth  all  the  dogs  used  in  the  experiments  —  to  make  no  men- 
tion of  the  many  other  lives  that  will  be  saved  in  all  the  future? 
1  Philadelphia  Medical  Times,  April  24,  1880. 


AND  MEDICAL  PROGRESS  11 

sufferings,  nor  the  sharp  pain  I  felt  when  I  learned,  two 
years  later,  how  I  might  possibly  have  saved  his  life.  In 
the  very  same  year  (1869),  Simon,  of  Heidelberg,  ^  had  a 
woman  under  his  care  suffering  from  urinary  fistula^  from 
a  healthy  kidney  —  a  surgical  accident  he  in  vain  tried  to 
heal.  That  she  could  live  with  one  kidney  had  the  other 
gradually  been  disabled  by  disease  was  probable,  for  one 
such  diseased  kidney  had  been  already  removed  three  times 
when  mistaken  for  ovarian  disease.  But  no  one  had 
removed  a  healthy  kidney,  and  then  studied  the  effects  on 
the  remaining  kidney  and  upon  the  heart;  no  one  had 
tested  what  was  the  best  method  of  reaching  the  kidney, 
whether  by  the  abdomen  or  the  loin,  or  how  to  deal  with 
its  capsule,  or  the  hemorrhage,  or  the  surgical  after-effects. 
Of  course,  Simon  could  have  tried  the  experiment  on  his 
patient,  blindly  trusting  to  Providence  for  the  result.  But 
he  chose  the  wiser  course.  He  studied  the  previous  litera- 
ture, experimented  on  a  number  of  dogs,  and  watched  the 
points  above  noted,  tried  various  methods  of  operating 
upon  the  dead  body,  and,  after  weighing  all  the  pros  and 
cons,  deliberately  cut  down  upon  the  kidney  of  his  patient 
after  a  carefully  formulated  plan,  not  by  the  abdomen,  but 
through  the  loin,  and  saved  her  life.  She  died  in  1877,  after 
eight  years  of  healthy  life,  free  from  her  loathsome  dis- 
order. 

Now,  what  have  been  the  results  of  these  experiments 
upon  a  few  dogs?  One  hundred  and  ninety-eight  times  the 
kidney  has  been  removed,  and  105  human  lives  have  been 
saved;  83  times  abscesses  in  the  kidney  have  been  opened, 
and  QQ  lives  saved;  17  times  stones  have  been  removed  from 
the  kidney  without  a  single  death  —  or,  in  all,  in  the  last 
fifteen  years,  298  operations,  and  188  human  lives  saved. 
Besides  this,  as  an  extension  of  the  operation  in  17  cases,  in 

*  Simon,  Chirurgie  der  Nieren,  1871,  preface. 

2  An  opening  in  the  skin  through  which  the  urine  constantly  escapes 
externally. 


12  ANIMAL  EXPERIMENTATION 

which  the  kidney,  having  no  such  attachments  as  ought  to 
anchor  it  in  place,  was  floating  loosely  in  the  abdomen  and 
was  a  source  of  severe  pain,  it  has  been  cut  down  upon  and 
sewed  fast  in  its  proper  place ;  and  all  of  these  patients 
but  one  recovered.^ 

Looking  to  the  future,  when  not  hundreds,  but  thou- 
sands, of  human  beings  will  enjoy  the  benefits  of  these 
operations,  and  in  increasing  percentages  of  recoveries,  are 
not  the  sufferings  inflicted  on  these  few  dogs  amply  justified 
as  in  the  highest  sense  kind  and  humane  P^ 

Not  long  since  Dr.  (later  Sir  David)  Ferrier,  of  London, 
was  prosecuted  for  the  alleged  performance  of  certain 
experiments  on  the  brains  of  the  lower  animals.  With 
Fritsch,  Hitzig,  Goltz,  Yeo,  and  others,  he  had  destroyed 
or  galvanized  certain  limited  areas  of  the  brain  (and  it  must 
not  be  forgotten  that  the  brain  is  wholly  without  the  sense 
of  pain),  and  so  determined  the  exact  nervous  centers  for 
certain  limited  groups  of  muscles.  As  a  result  of  their 
labors,  the  brain  is  now  mapped  out  with  reasonable  ac- 
curacy, so  that,  given  certain  hitherto  ill-understood  or 
obscure  localized  symptoms,  we  can  now  say  that  there  is 
certainly  a  tumor,  an  abscess,  or  other  disease  in  precisely 
this  or  that  locality.  True,  we  can  doubtfully  infer  some- 
what of  the  same  from  the  cruel  experiments  of  disease  on 

^  In  the  twenty-nine  years  since  this  address  was  delivered  these  figures 
have  been  multiplied  many  fold.   (1914.) 

2  Very  erroneous  views  prevail  as  to  the  sufferings  of  animals  from 
experiments  upon  them.  Many  persons  suppose  that  "vivisection" 
means  deliberate  "cutting  up"  of  an  animal  without  using  any  anesthetic, 
little  by  little,  till  not  enough  is  left  to  live.  So  far  is  this  from  the  truth, 
that  Professor  Gerald  Yeo,  from  the  actual  reports  of  vivisectionists  in 
England  (Fortnightly  Review,  March,  1882),  estimates  that  of  one  hun- 
dred such  experiments,  there  are:  — 

Absolutely  painless       75 

As  painful  as  vaccination 20 

As  painful  as  the  healing  of  a  wound 4 

As  painful  as  a  surgical  operation       1 

Total         100 


AND  MEDICAL  PROGRESS  13 

man.  But  nature's  experiments  are  rarely  ever  limited  in 
area  or  uncomplicated;  they  are  never  systematic  and  ex- 
haustive; it  takes  years  to  collect  a  fair  number  of  her 
clumsy  experiments,  and  the  knowledge  is  diffused  through 
many  minds  instead  of  being  centered  in  one  that  will  sys- 
tematize the  results. 

Said  Ferrier,  a  year  ago,  in  the  Marshall  Hall  Oration, 
"There  are  already  signs  that  we  are  within  measurable 
distance  of  the  successful  treatment  by  surgery  of  some  of 
the  most  distressing  and  otherwise  hopeless  forms  of  intra- 
cranial disease,  which  will  vie  with  the  splendid  achieve- 
ments of  abdominal  surgery." 

Note  the  fulfillment!  Last  fall,  within  a  year  of  the  fore- 
going prophecy,  a  man,  aged  twenty-five,  entered  the 
London  Hospital  for  Epilepsy  and  Paralysis.^  From  the 
symptoms,  which  I  need  not  detail.  Dr.  Hughes  Bennett, 
basing  his  conclusions  on  Ferrier's  experiments,  diagnos- 
ticated a  tumor  of  small  size,  involving  the  center  of  motion 
for  the  muscles  of  the  hand.  On  November  15,  1884,  at  his 
instance,  Mr.  (later  Sir  Rickman  J.)  Godlee  trephined  the 
skull  over  the  selected  spot,  and  a  quarter  of  an  inch 
below  the  surface  of  the  brain  found  a  tumor  as  big  as  a 
walnut,  and  removed  it.  For  three  weeks  the  man  did  well, 
but  died  on  the  thirty-eighth  day  from  blood-poisoning, 
such  as  might  follow  any  operation,  especially  a  new  one. 
Macewen,  of  Glasgow,  ^  has  similarly  trephined  a  woman, 
the  victim  of  slow  paralysis  of  body  and  mind,  and  opened 
an  abscess  a  little  distance  below  the  surface,  letting  out 
two  teaspoonfuls  of  pus,  and  followed  by  entire  mental 
and  physical  recovery. 

By  these  experiments  and  operations  a  wide  door  is  open 
to  surgery  in  the  treatment  of  diseases  within  the  skull  — 
diseases  heretofore  so  obscure  and  uncertain  that  we  have 
hardly  dared  to  attack  them.  The  question  is  not  whether 

1  Medical  News,  January  17,  1885. 
^Medical  News,  January  3,  1885. 


14  ANIMAL  EXPERIMENTATION 

death  or  recovery  followed  in  these  particular  cases.  The 
great,  the  startling,  the  encouraging  fact  is  that,  thanks  to 
these  experiments,  we  can  now,  with  well-nigh  absolute 
certainty,  diagnosticate,  and  with  the  greatest  accuracy 
locate  such  diseases,  and  therefore  reach  them  by  opera- 
tion, and  treat  them  successfully.^  Would  that  I  had  been 
born  twenty-five  years  later,  that  I  might  enjoy  with  you 
the  full  luxury  of  such  magnificent  life-saving,  health- 
giving  discoveries! 

It  is,  however,  by  the  experimental  study  of  the  effects  of 
minute  organisms  —  microbes,  as  they  are  now  called  — 
that  some  of  the  latest  and  most  remarkable  results  have 
been  achieved.  The  labors  of  Koch,  Pasteur,  Klein,  Cheyne, 
Tommasi-Crudeli,  Wood,  Formad,  Sternberg,  and  others 
are  now  known  even  to  the  daily  press.  Let  us  see  what 
they  have  done. 

It  is  but  three  years  since  Koch  announced  that  con- 
sumption was  caused  by  the  "bacillus  tuberculosis." 
Later  he  had  studied  cholera  and  found  the  "comma 
bacillus,"  to  which  he  ascribes  that  dreaded  disease.  In 
spite  of  the  opposition  of  prominent  scientists,  his  views 
have  been  in  general  accepted,  and  seem  to  be  reasonable. 
[How  odd  all  these  words  sound  after  30  years !] 

The  method  of  experiment  is  simple,  though  difficult. 
The  suspected  expectoration  or  discharge  is  placed  in  a 
suitable  soil,  and  after  cultivation  some  of  this  growth  is 
placed  in  another  culture-soil,  and  so  on  till  generation 
after  generation  is  produced,  the  violence  of  the  poison 

^  In  1899  —  only  fourteen  years  after  this  address  was  delivered — 
Knapp  collected  491  operations  for  brain  tumors  in  which  the  result  was 
known.  In  64  operations  for  palliation  —  i.e.,  relief  of  pain,  etc.  —  only  4 
died;  in  275  completed  operations  82  died  (30  per  cent) ;  in  152  inoperable 
and  incompleted  cases  86  died  (56  per  cent).   (1905.) 

A  larger  experience  has  developed  diflSculties  unknown  thirty  years 
ago,  in  the  exact  localization  and  therefore  in  the  operability  of  such 
tumors.  But  the  main  fact  to  be  remembered  is  that  before  these  investi- 
gations every  case  of  brain  tumor  was  fatal.  Hence  every  case  of  recovery 
is  one  life  saved.  (1914.) 


AND  MEDICAL  PROGRESS  15 

being  modified  by  each  culture.  A  small  portion  of  any 
one  of  these  cultures  is  then  injected  under  the  skin  of  a 
mouse  or  other  animal,  and  in  time  it  dies  or  is  killed,  and 
the  results  are  verified  by  the  post-mortem. 

So  exact  is  the  knowledge  in  tuberculosis  now  that  Koch 
can  predict  almost  to  an  hour  when  the  mouse  will  die  of 
consumption,  or  that  it  will  escape,  according  to  the  culture 
used. 

It  is  far  too  early  as  yet  to  say  that  these  studies  have 
borne  the  immense  practical  fruit  that  the  next  few  years 
will  show;^  but  they  have  already  enabled  us  to  recognize 
by  the  microscope  doubtful  cases  of  consumption  in  their 
earlier  and  more  remediable  stages,  and  have  made  certain 
what  has  hitherto  been  only  a  probability  —  that  consump- 
tion is  distinctly  contagious. 

By  Gerlach's  experiments  on  animals  with  the  milk  from 
tuberculous  cows,  also,  it  has  been  shown  that  consumption 
may  be  contracted  from  such  milk.  How  important  this 
conclusion  is,  in  so  universal  an  article  of  food  to  young 
and  old,  I  need  not  do  aught  than  state. 

The  experiments  of  Wood  and  Formad  on  diphtheria  I 
have  already  alluded  to.  Those  of  Tommasi-Crudeli  also 
have  shown  that  probably  the  poison  of  malaria  is  due  to 
like  organisms,  while  a  large  number  of  other  diseases  are 
being  similarly  investigated. ^ 

As  to  cholera,  the  classic  experiments  of  Thiersch,  in 
1853,^  are  well  known.  He  inoculated  56  mice  with  cholera 
discharges.  Of  these,  44  sickened  and  14  died  from  chol- 
eraic diseases.  In  the  same  year  two  water  companies  in 
London  experimented  on  500,000  human  beings,  one  of 

*  As  a  result  of  this  discovery  and  the  methods  of  sanitation  based  upon 
it,  the  death-rate  of  tuberculosis  has  been  reduced  in  various  cities  by 
from  thirty  to  fifty  per  cent.  (1914.) 

2  Later  experiments  by  Laveran  and  others  have  definitely  settled  the 
microbial  origin  of  malaria  and  also  that  only  one  species  of  mosquito 
is  responsible  for  the  spread  of  the  disease.  (1914.) 

'  John  Simon,  Proceedings,  International  Medical  Congress,  London, 
1881. 


10  ANIMAL  EXPERIMENTATION 

them  inoculating  its  patrons  with  cholera  discharges 
through  its  impure  water-supply.  This  one  sickened 
thousands  and  killed  3476  human  beings,  most  of  whom 
might  have  escaped  had  the  lessons  of  Thiersch's  14  mice 
been  heeded.  To  ask  the  question,  which  was  the  more 
cruel,  is  to  answer  it.^ 

At  present  our  strenuous  efforts  are  all  in  one  direction  — 
namely,  to  study  these  microbes  by  the  microscope,  by 
clinical  observation,  and  by  experiments  on  animals,  in 
order  to  find  out  their  origin,  causes,  growth,  and  effects, 
and  to  discover  by  what  means  their  deadly  results  may 
be  avoided,  or  by  what  remedies,  without  harm  to  the 
patient,  they  may  themselves  be  destroyed.  Evidently 
these  studies  cannot  be  tried  on  our  patients.  They  must 
either  be  tried  on  animals  or  be  abandoned. 

The  inoculation  experiments  of  modem  times  have 
recently  borne  rich  fruit  in  still  another  pestilential  disease 
—  yellow  fever  —  whose  ravages  in  this  country  are  fresh 
in  our  minds.  November  10,  1884,  M.  Bouley  reported  to 
the  Paris  Academy  of  Sciences^  that,  since  1880,  M.  Freire, 
of  Rio  Janeiro,  had  experimented  on  guinea-pigs  with  the 
virus  of  yellow  fever,  and  believed  that  he  had  been 
able  to  produce  such  attenuation  of  the  virus  that  by  vac- 
cination he  could  secure  immunity  from  this  dreadful 
scourge.  Following  the  experiments,  he  and  Rabourgeon 
tested  the  results  on  themselves,  some  students  of  medicine, 

*  The  population  supplied  by  the  Southwark  and  Vauxhall  Company, 
in  the  epidemic  of  1848-49,  died  at  the  rate  of  118  in  each  10,000,  and, 
in  that  of  1853-54,  at  the  rate  of  130  per  10,000.  Those  supplied  by  the 
Lambeth  Company  died  in  1848-49  at  the  rate  of  125  per  10,000,  but 
having  improved  its  water-supply  meantime,  the  death-rate,  in  1853-54, 
fell  to  37  per  10,000. 

If  Thiersch  lived  in  England  to-day,  he  would  have  to  take  out  a  license 
to  kill  his  fourteen  mice  in  the  interests  of  humanity  —  a  license  possibly 
refused,  or  only  to  be  obtained  after  the  most  vexatious  delays.  But 
any  housemaid  might  torture  and  kill  them  with  arsenic  or  phosphorus, 
or  Thiersch  might  give  them  to  a  favorite  terrier  without  the  slightest 
interference,  provided  only  it  be  not  for  a  scientific  or  a  humane  object.' 

*  Medical  News,  November  29,  1884. 


I 


AND  MEDICAL  PROGRESS  17 


and  employees.  Later  the  Emperor  Dom  Pedro  authorized 
two  hundred  wharf-laborers  to  be  inoculated.  All  these, 
after  a  three  days'  mild  attack,  remained  free  from  the 
pestilence,  while  their  fellow  laborers,  similarly  exposed 
to  the  fever,  were  dying  on  every  hand.  If,  in  an  epidemic, 
this  still  prove  true,  as  there  seems  every  probabihty  it  will, 
from  the  five  hundred  lives  already  saved,  we  can  hardly 
estimate  either  the  medical  or  the  commercial  advantages 
to  this  country  alone.  Is  this  cruelty?  Let  Norfolk,  and 
Memphis,  and  Pensacola,  and  New  Orleans  answer.^ 

We  are  all  familiar  now  with  the  numerous  deaths  from 
eating  pork  infested  with  trichina.  While  I  was  in  Berlin, 
in  1865-66,  a  terrible  epidemic  of  the  then  new  disease 
broke  out  at  Hedersleben,  a  small  town  in  Prussian 
Saxony.  I  well  remember  with  what  zeal  Virchow  and  his 
assistants  immediately  investigated  the  disease,  inoculated 
animals  with  the  parasitic  worm,  studied  its  natural  his« 
tory,  found  out  that  heat  killed  it,  and  to-day,  as  a  result 
of  these  and  other  experiments,  we  all  know  how  to  avert 
its  dangers  by  proper  cooking,  or  to  avoid  it  altogether  by 
the  microscope.  The  value  of  these  experiments,  both  to 
human  life  and  to  commerce,  you  know  even  from  the  daily 
papers. 

You  will  find  it  difficult  to  make  the  non-medical  public 
understand — nay,  you  yourselves  as  yet  hardly  imder- 
stand  —  the  enormous  advance  in  medicine  and  surgery 
brought  about  by  recent  researches  on  inflammation,  and  by 
the  use  of  antiseptics.  My  own  professional  life  only  covers 

*  Since  then  the  brilliant  researches  of  Major  Reed,  Colonel  (now 
Brigadier-General)  Gorgas,  and  other  American  army  officers  in  Cuba 
have  shown  that  the  mosquito  is  the  only  source  of  propagation  of  yellow 
fever.  The  cause  of  yellow  fever  is  still  imknown,  but  mosquito  bars 
guard  against  the  fever,  as  our  knowledge  has  been  augmented,  and  Cuba 
and  the  United  States  have  been  freed  from  this  pestilence  and  its  ravages 
among  human  beings  and  its  commercial  disasters. 

So  completely  has  yellow  fever  been  eliminated  that  since  May  17, 
1906,  —  over  eight  years!  —  not  a  single  ease  of  yellow  fever  has  arisen  in 
the  Canal  Zone!  (1914.) 


18  ANIMAL  EXPERIMENTATION 

twenty-three  years,  yet  in  that  time  I  have  seen  our  knowl- 
edge of  inflammation  wholly  changed,  and  the  practice  of 
surgery  so  revolutionized  that  what  would  have  been  im- 
possible audacity  in  1862  has  become  ordinary  practice  in 
1885. 

It  would  seem  that  so  old  a  process  as  inflammation 
would  long  ago  have  been  known  through  and  through, 
and  that  nothing  new  could  be  adduced.  In  1851,  however, 
Claude  Bernard,  by  a  slight  operation,  divided  the  sym- 
pathetic nerve  in  a  rabbit's  neck  and  showed  its  influence 
on  the  caliber  of  the  blood-vessels.  In  1858  Virchow  pub- 
lished his  "Cellular  Pathology."  In  1867  Cohnheim  pub- 
lished his  studies  on  the  part  that  the  blood-cells  played  in 
inflammation  as  shown  in  the  frog,  followed  by  further 
papers  by  Dr.  Norris,  of  this  city,  Strieker,  Von  Reckling- 
hausen, Waldeyer,  and  many  others.  Already  in  my  lec- 
tures I  have  pointed  out  to  you  in  detail  the  advances  made 
by  these  studies,  both  in  theory  and  practice.  They  have 
brought  about  an  entire  reinvestigation  of  disease,  and 
given  us  wholly  new  knowledge  as  to  abscesses,  ulceration, 
gangrene,  the  organization  of  clots  in  wounds,  and  after 
operations  and  ligature  of  blood-vessels  for  aneurism,  as  to 
thrombosis,  and  embolism,  and  paralysis,  and  apoplexy, 
and  a  score  of  other  diseases  through  the  diagnosis  and 
treatment  of  which  now  runs  the  silver  thread  of  knowledge 
instead  of  ignorance. 

With  this  the  brilhant  results  of  the  antiseptic  system 
have  joined  to  give  us  a  new  surgery.  Sir  Joseph  (later  Lord) 
Lister,  to  whom  we  chiefly  owe  this  knowledge,  has  done 
more  to  save  human  life  and  diminish  human  suffering  than 
any  other  man  of  the  last  fifty  years.  Had  he  only  made 
practicable  the  use  of  animal  ligatures,  it  would  have  been 
an  untold  boon,  the  value  of  which  can  only  be  appreciated 
by  doctors;  but  he  has  done  far  more,  he  has  founded  a  new 
system  of  surgery.  We  may  reject  the  spray  and  carbolic 
acid,  but  the  surgical  world,  regardless  of  details,  with  few 


AND  MEDICAL  PROGRESS  1ft 

exceptions  follows  the  principles  upon  which  his  method  is 
founded  and  humanity  is  the  gainer,  by  the  nearly  total 
abolition  of  inflammation,  suppuration,  secondary  hemor- 
rhage, blood-poisoning,  gangrene,  erysipelas,  lockjaw,  and 
"  hospital  gangrene,*'  as  sequels  of  accidents  and  opera- 
tions; by  the  relief  from  suffering  and  death,  by  operations 
formerly  impossible;  by  rendering  amputations  and  com- 
pound fractures  safe  and  simple  instead  of  deadly.  Re- 
flect on  what  each  one  of  these  brief,  but  momentous, 
statements  means !  ^ 

But  we  have  by  no  means  reached  perfection.  Lister 
himself,  no  tyro,  but  the  great  master,  is  still  searching  for 
further  improvements.  But  when  lately  he  desired  to  make 
some  experiments  on  animals,  still  further  to  perfect  our 
practice,  so  many  obstructions  were  thrown  in  his  way  in 
England  that  he  was  driven  to  Toulouse  to  pursue  his 
humane  researches. 

1  had  intended  also  to  speak  of  many  other  practical 
benefits  to  man  directly,  but  can  only  mention  such  im- 
portant matters  as  the  surgery  of  the  thyroid  gland,  the 
seat  of  goiter;  the  surgery  of  the  lungs,  parts  of  which  have 
been  removed;  the  surgery  of  the  nerves;  removal  of  the 
entire  larynx;  the  remarkable  researches  of  late  years  as 
to  the  periosteum  in  the  reproduction  of  new  bone  after 
removal  of  dead  or  diseased  bone;  Bernard's  important  ob- 
servations as  to  diabetes;  Brown-Sequard's  experiments  on 
epilepsy;  the  modern  extraordinary  advance  in  nearly  all 
the  diseases  of  the  nervous  system,  and  a  number  of  other 
discoveries,  as  to  all  of  which  experiments  upon  animals 
have  added  largely  to  our  knowledge,  and  therefore  to  our 
means  of  diminishing  suffering  and  saving  human  life.  For 
many  of  these,  as  well  as  for  the  most  judicial  discussion  of 
the  vivisection  question  I  have  yet  seen,  I  must  refer  you 
to  that  remarkable  book,  "Physiological  Cruelty." ^ 

^  These  splendid  results  are  described  in  later  papers  in  this  volume. 

2  See  also  the  Lije  and  Labors  of  Pasteur^  by  Vallery-Radot. 


20  ANIMAL  EXPERIMENTATION 

I  had  also  intended  to  refer  in  detail  to  the  splendid 
results  of  vivisection  in  relieving  the  sufferings  of  animals, 
and  in  preventing  enormous  pecuniary  loss  to  man.  We 
are  only  beginning  to  see  that  vivisection  is  as  humane  to 
animal  life  and  suffering  as  it  is  to  human,  and  that  for 
financial  reasons  as  well  as  humane  motives  it  is  of  the 
utmost  importance  to  the  State  that  such  diseases  as  cattle 
plague,  splenic  fever,  chicken  cholera,  swine  plague,  and 
others,  should  be  eradicated.  Vivisection  has  shown  us 
how  this  may  be  done,  and  has  so  conferred  upon  animals, 
too,  the  boon  of  life  and  health.  For  all  this,  however,  I 
must  refer  you  to  the  recent  admirable  lecture  by  Professor 
Robert  Meade  Smith,  of  the  University  of  Pennsylvania.^ 

One  subject,  however,  is  so  recent  and  of  such  interest, 
both  to  man  and  animals,  that  I  must  not  pass  it  over — I 
mean  that  justly  dreaded  disease  hydrophobia.  Thanks  to 
vivisection,  its  abolition  in  the  near  future  seems  no  longer 
to  be  a  matter  of  doubt. 

Within  the  last  three  years  Pasteur  has  announced  that, 
by  passing  the  virus  through  the  monkey,  he  has  been  able 
to  protect  dogs  from  hydrophobia  by  vaccination  with  this 
weakened  virus.  The  French  Government  recently  ap- 
pointed an  eminent  scientific  commission  to  report  on  the 
alleged  discovery.  ^  Pasteur  furnished  them  with  23  vac- 
cinated dogs.  These  23,  and  19  others  unprotected,  were 
all  inoculated  from  rabid  animals.  Of  the  19  unprotected, 
14  died.  Of  the  23  protected  dogs,  1  died  of  diarrhea,  and 
all  the  others  escaped.  It  has  yet  to  be  tried  on  a  man 
suffering  from  hydrophobia,  but,  should  our  reasonable 
hopes  be  realized,  what  a  boon  it  will  be!  ^ 

1  Therapeutic  Gazette,  November,  1884. 

2  Medical  News,  August  30,  1884. 

^  "Pasteur  Institutes"  for  the  treatment  of  hydrophobia  and  some 
similar  diseases  have  been  established  in  nearly  every  civilized  country  in 
the  world.  Of  persons  bitten  by  animals  believed  to  be  rabid,  heretofore 
about  sixteen  per  cent  developed  hydrophobia,  and  every  one  died.  In  the 
thousands  of  such  cases  treated  by  Pasteur's  method  even  those  bitten  by 
animals  knovm  to  be  rabid  the  mortality  is  less  than  one  per  cent,    (1914.) 


AND  MEDICAL  PROGRESS  21 

With  this  brief  summary  of  a  few  of  the  recent  practical 
benefits  from  vivisection,  I  must  close.  I  have  given  you 
only  ascertained  facts  for  your  future  use  in  the  communi- 
ties in  which  you  may  settle.  They  may  assist  you  in  form- 
ing public  sentiment  on  a  basis  of  fact,  of  reason,  and  of 
common  sense.  The  sentiment  of  our  own  profession,  so 
constantly  and  so  conspicuously  humane,  is  always  against 
inflicting  pain;  but  if  in  yielding  to  sentiment  we  actually 
increase  disease,  and  pain,  and  death,  both  among  animals 
and  men,  our  aversion  to  present  pain  is  both  unwise  and 
actually  cruel. 


RECENT  PROGRESS  IN  SURGERY* 

In  no  department  of  medicine  has  there  been  more  rapid 
and  in  many  respects  more  astonishing  progress  in  recent 
years  than  in  surgery.  This  progress  is  due  chiefly  to  two 
things  —  the  introduction  of  antiseptic  methods,  and  to 
what  we  have  learned  from  laboratory  work  and  experi- 
ments upon  animals. 

It  has  long  been  known  that  a  "simple"  fracture,  in 
which  the  skin  is  unbroken,  and  a  "compound"  fracture, 
in  which  the  skin  is  broken  and  the  air  has  easy  access  to 
the  fractured  bone,  were  vastly  different  in  their  dangers; 
but  why  the  communication  with  the  air  was  so  dangerous 
was  a  mystery.  Of  late  years,  however,  the  germs  existing 
in  the  atmosphere,  and  on  every  material  coming  into  con- 
tact with  the  wound,  such  as  dirty  clothing,  ordinarily 
clean  instruments,  the  skin  of  the  patient,  the  hands  of  the 
surgeon,  and  the  dressings,  have  been  investigated  by  a 
large  number  of  observers,  and  it  has  been  abundantly 
proved  that  infection  comes  not  from  the  wound  itself,  but 
from  the  exterior,  and  that  this  infection  from  without  is 
the  cause  of  inflammation  and  of  its  speedy  sequel,  the 
formation  of  "pus"  (that  is,  "matter").  Once  that  the 
pus  begins  to  form,  fever,  abscesses,  blood-poisoning,  gan- 
grene, erysipelas,  one  or  all,  may  start  up  into  ominous 
and  fatal  activity.  Inflammation  and  suppuration  (that 
is,  the  formation  of  pus),  then,  are  the  causes  of  all  these 
evil  processes.  They  are  all  called  briefly  "septic"  (that  is, 
"poisonous")  processes.  Hence  "antiseptic"  methods  are 
those  that  prevent  inflammation  and  suppuration. 

Now  we  see  why  a  compound  fracture,  or  any  other 

*  Reprinted  from  Harper's  Magazine,  October,  1889,  by  the  kind  con- 
sent of  Messrs.  Harper  &  Brothers. 


I 


MEDICAL  PROGRESS  23 

"open  "  wound  (that  is,  one  in  which  the  protective  defense 
of  the  skin  is  destroyed),  is  so  much  more  dangerous  than  a 
simple  fracture,  or  a  subcutaneous  wound.  It  arises  from 
the  fact  that  these  septic  germs,  or  "microbes,"  have  easy 
access  to  the  tissues,  and,  once  there,  multiply  with  almost 
incredible  rapidity,  and  quickly  set  up  inflammation  and 
suppuration  and  their  consequences.  At  first  it  was  thought 
that  the  chief  danger  lay  in  atmospheric  germs,  but  later 
investigations  have  proved  that  the  skin  of  the  patient, 
and  especially  the  hands  of  the  surgeon,  and  his  instru- 
ments and  sponges,  and  even  his  dressings,  are  far  more 
frequent  sources  of  infection. 

Perhaps  I  cannot  better  illustrate  the  difference  between 
the  old,  or  "septic,"  and  the  new,  or  "antiseptic,"  surgery 
than  by  describing  two  amputations,  one  such  as  was  com- 
monly done,  for  instance,  during  the  Civil  War,  and  the 
other  such  as  is  done  now  by  every  good  surgeon.  In  fact, 
it  is  only  within  the  last  ten  or  fifteen  years  that  antiseptic 
surgery  has  become  generalized  in  the  profession. 

Let  us  suppose  an  amputation  above  the  elbow,  and  the 
operator  the  best  surgeon  of  the  Civil  War.  The  arm  was 
not  specially  prepared,  except  that  it  would  be  cleaned  of 
its  coarse  dirt  arising  from  the  accident,  but  that  would  be 
all.  The  instruments  were  taken  out  of  an  ordinary  case 
and  placed  on  a  table,  and  during  the  operation  were  fre- 
quently placed  upon  the  patient's  clothing,  soiled  often  by 
the  accident  necessitating  the  operation,  as  well  as  by  more 
or  less  wearing.  If  the  instruments  or  sponges  fell  upon  the 
floor,  they  would  be  picked  up,  dipped  into  water,  and  then 
used  with  innocent  equanimity.  The  sponges,  washed  and 
dried  from  the  last  operation,  were  simply  thrown  into  a 
basin  of  ordinary  water.  The  hands  of  the  surgeon  were  as 
clean  as  a  gentleman  would  always  keep  his  hands.  The 
amputation  having  been  done,  the  arteries  were  tied  with 
silk  threads  (called  "ligatures"),  one  end  of  each  being  left 
long.  These  long  ends  were  left  hanging  out  of  the  wound 


24  ANIMAL  EXPERIMENTATION 

at  any  convenient  place,  and  in  an  amputation  of  a  muscu- 
lar thigh  might  number  a  score  or  more.  Hemorrhage 
having  been  checked,  the  two  flaps  were  sewed  together 
with  wire  or  silk  threads,  called  "sutures."  In  threading 
the  needle,  the  silk  thread  would  often  be  shaped  into  a 
point  by  the  lips,  or,  after  being  wetted  with  septic  saliva, 
would  be  rolled  between  septic  fingers.  A  piece  of  lint,  or 
often  a  piece  of  soft,  old  linen  "rag,"  spread  with  some 
grease,  was  placed  upon  the  stump,  and  a  suitable  bandage 
applied.  The  next  day  the  dressings  were  removed,  and 
the  wound  was  redressed  in  a  similar  manner.  At  the  end 
of  twenty-four  or  forty-eight  hours  a  fever  would  set  in, 
called  in  our  textbooks  "surgical  fever,"  thus  assuming 
that  a  surgical  operation  always  resulted  in  such  a  fever; 
nor  was  the  assumption  erroneous  at  that  time.  This  would 
continue  for  several  days,  the  temperature  ranging  from 
102°  to  104°  or  105°  F.  In  a  few  days,  when  suppuration 
became  established  (and  this  was  always  expected  by  the 
surgeon),  the  fever  would  gradually  subside,  and  later  the 
suppuration  also  would  diminish.  At  the  end  of  a  week  or 
ten  days  the  surgeon  would  pull  gently  on  each  silk  liga- 
ture, to  see  if  it  had  rotted  loose  from  the  blood-vessel  and 
could  be  removed.  If  the  wound  became  unduly  inflamed, 
poultices  would  be  applied;  and  finally,  after  three  or  four 
weeks,  the  ligatures  would  all  have  been  removed,  and 
the  wound  soon  be  healed.  Very  rarely,  indeed,  would  a 
wound  heal  without  suppuration.  If  it  did,  it  always  excited 
remark,  and  would  be  recounted  as  a  surgical  triumph. 
Very  often,  on  the  other  hand,  grave  complications  arose  by 
the  formation  of  abscesses;  erysipelas  and  gangrene  were 
fertile  sources  of  danger,  and  very  often  of  death;  while 
secondary  hemorrhage — that  is,  hemorrhage  following  pre- 
mature rotting  of  the  ligatures  on  the  blood-vessels — was 
always  a  possible,  and  frequently  an  actual  and  formidable, 
danger  to  life.  A  serious  operation  from  which  the  patient 
recovered  in  less  than  a  month  was  a  "remarkable  case." 


AND  MEDICAL  PROGRESS  25 

Contrast  this  with  a  similar  operation  performed  to-day 
by  any  ordinarily  well-instructed  surgeon.  The  day  before- 
hand the  skin  in  a  wide  area  around  the  site  of  the  proposed 
operation  will  first  be  scrubbed  by  a  nail-brush  with  soap 
and  water,  then  with  ether,  then  with  some  antiseptic 
solution,  —  most  frequently  at  the  present  day  a  solution 
of  corrosive  sublimate,  one  part  to  one  thousand  of  water, 
—  and  then  covered  with  an  antiseptic  dressing  until  the 
operation  is  begun.  The  object  of  this  is  to  free  the  skin 
from  dirt  and  fatty  matter,  making  it  surgically  clean  and 
free  from  germs.  The  instruments  will  have  been  boiled 
in  a  covered  vessel  for  fifteen  minutes,  or  disinfected  by 
carbolic  acid  or  some  equivalent  germicide,  and  are  then 
placed  in  a  tray  filled  with  an  antiseptic  solution.  In  the 
cleaning  of  them  after  the  last  operation  all  rough  and  more 
or  less  inaccessible  places  where  germs  may  accumulate 
(especially,  for  instance,  the  joints)  will  have  been  scrupu- 
lously disinfected.  If  during  the  operation  an  instrument  is 
laid  down,  it  is  never  placed  on  the  clothing  of  the  patient, 
but  either  is  replaced  in  the  tray,  or  laid  upon  towels  or 
sheets  which  have  been  disinfected  and  spread  all  over  the 
patient's  person  and  clothing  all  around  the  field  of 
operation. 

After  an  operation  the  sponges  are  thrown  away  if  they 
have  become  infected  from  pus;  but  if  not,  they  are  very 
carefully  disinfected,  and  then  kept  permanently  in  a 
carbolic  solution.^  At  the  next  operation  they  are  placed 
in  a  tray  containing  some  antiseptic,  or  at  least  water  which 
has  been  boiled,  for  heat  has  been  found  to  be  one  of  the 
best  antiseptics.  If  a  sponge  or  an  instrument  fall  on  the 
floor,  it  is  laid  aside,  or  before  being  used  again  is  thoroughly 
disinfected.  The  hands  of  the  surgeon  will  next  receive 
especial  care.  First  they  are  scrubbed  with  soap  and  water 
and  a  nail-brush.  Then  the  nails  are  cleaned  anew,  for  the 

^  Later  gauze  "sponges'*  have  practically  displaced  these  "marine" 
sponges. 


26  ANIMAL  EXPERIMENTATION 

dirt  which  accumulates  under  them  is  found  to  be  one  of 
the  most  fruitful  sources  of  infection.  Then  the  hands  are 
washed  in  pure  alcohol,  and  last,  while  wet,  are  again 
scrubbed  with  the  antiseptic  solution,  the  nails  again 
receiving  great  care.  If  during  the  operation  the  hands 
touch  anything  not  itself  already  disinfected,  they  must 
again  be  disinfected. 

These  precautions  being  complete,  the  operation  Is  begun. 
The  blood-vessels  are  tied  with  catgut  or  silk  which  has 
been  disinfected,  and  both  ends  are  cut  short.  These  liga- 
tures are  not  irritating  like  the  non-disinfected  silk  formerly 
used.  As  no  end  hangs  out,  they  are  never  pulled  upon, 
but  are  slowly  absorbed,  and  nothing  is  ever  heard  of  them 
again.  In  consequence  of  this  the  blood-vessels  are  never 
afterward  disturbed,  and  secondary  hemorrhage  is  now  one 
of  the  rarest  compUcations  following  an  operation.  A  dis- 
infected rubber  tube,  with  holes  in  it  for  draining  away 
the  wound  fluids,  which  ooze  from  the  raw  surfaces  for 
some  time,  is  then  inserted  between  the  flaps,  with  a  bundle 
of  horse-hairs  alongside  of  it.  The  flaps  are  now  united  by 
sutures  of  catgut,  disinfected  as  before,  or  sutures  of  wire 
or  of  silk  similarly  prepared.  A  large,  soft  dressing  of  many 
layers  of  dry  cheese-cloth  is  next  applied  by  a  bandage.  This 
dressing  has  been  thoroughly  impregnated  with  corrosive 
sublimate  or  some  other  antiseptic  solution.  The  finest 
linen  or  lint,  clean  as  the  driven  snow  to  the  ordinary  eye, 
is  dirty  to  the  eye  of  an  antiseptic  surgeon,  since  it  is  not 
cleansed  from  the  microscopical  germs  that  will  surely 
cause  infection.  At  the  end  of  twenty-four  hours  the  drain- 
age tube  is  removed,  the  horse-hairs  being  sufficient  for 
the  slight  later  drainage,  and  another  similar  dressing  of 
dry  antiseptic  cheese-cloth  is  applied.  The  horse-hairs  are 
entirely  removed  after  four  or  five  days.^ 

The  temperature  of  the  patient  after  the  operation 

*  Since  1889  this  "ritual"  has  been  much  simplified  and  at  the  same 
time  is  more  efficient.   (1914.) 


AND  MEDICAL  PROGRESS  27 

scarcely  rises  above  the  normal.  Apart  from  the  discomfort 
of  the  ether- vomiting,  from  shock,  and  from  loss  of  blood 
(from  all  of  which  the  patient  generally  recovers  in  twenty- 
four  hours  or  less),  he  will  suffer  but  little  pain.  It  is  not 
an  infrequent  thing  to  see  a  patient  recover,  even  from  a 
severe  operation,  without  having  suffered  much  pain.  By 
the  fifth  or  the  tenth  day,  when  the  second  dressing  will  be 
applied,  the  wound  is  well.  No  complications  ought  to 
occur,  saving  in  exceptional  cases.  Secondary  hemorrhage 
is  unknown.  Primary  union  of  the  flaps  is  now  always 
expected.  The  formation  of  pus  is  a  rare  accident;  if  it  does 
occur,  the  surgeon  asks  himseK,  "What  mistake  did  I 
make?" 

Let  us  now  see  what  the  results  have  been  in  amputa- 
tions. In  Professor  Billroth*s  clinic  in  Vienna,  in  the  seven- 
teen years  from  1860  to  1877,  there  were  315  major  ampu- 
tations done  (i.e.,  excluding  fingers  and  toes)  in  the  most 
approved  methods  of  the  days  before  antiseptics  were 
introduced.  Of  these,  173,  or  54  per  cent,  died.  From  1877 
to  1880,  91  such  amputations  were  done  by  the  same  sur- 
geon with  antiseptic  precautions,  and  the  mortality  fell  to 
18,  that  is,  19.7  per  cent  —  nearly  one  third  of  the  former 
rate.  Of  the  91  cases,  56  were  uncomplicated  cases,  of 
whom  not  one  died.  The  general  rates  of  mortality  in 
amputations  in  different  hospitals  in  the  days  before  anti- 
septics were  employed  have  ranged  from  23  to  over  53  per 
cent.  Since  the  introduction  of  antiseptics  some  idea  of  the 
saving  of  life,  to  say  nothing  of  the  immense  decrease  of 
pain  and  suffering,  may  be  gathered  from  the  following 
additional  figures:  In  Von  Brun's  clinic,  47  major  amputa- 
tions were  done  antiseptically,  and  not  one  died.  Busch 
reports  57  similar  amputations,  with  a  mortality  of  3.5  per 
cent;  Schede,  31  amputations  with  a  mortality  of  4.37  per 
cent;  Socin,  48  amputations,  and  a  mortality  of  zero;  and 
Volkmann,  220  amputations,  with  a  mortality  of  but  3.5 
per  cent.    I  have  purposely  quoted  the  statistics  of  six 


g8  ANIMAL  EXPERIMENTATION 

operators  so  as  to  show  that  it  is  not  the  man,  but  the 
method,  which  has  yielded  such  splendid  results. 

This  perfection  has  been  reached  by  an  immense  deal  of 
labor  on  the  part  of  many  observers,  first  and  foremost, 
primus  inter  pares.  Sir  Joseph  (later  Lord)  Lister,  now  of 
London.  The  experiments  have  been  made  chiefly  in  two 
directions.  First,  on  animals,  to  discover  what  was  the 
best  method  of  treating  wounds,  and  especially  to  select 
the  best  material  for  ligatures  and  sutures  by  which  to  tie 
the  bleeding  vessels  and  unite  the  flaps,  the  object  being  to 
obtain  that  material  which  would  not  carry  infection,  and 
which,  at  an  early  date,  would  be  entirely  absorbed  —  yet 
not  at  too  early  a  date  lest  the  blood-vessels  should  not  be 
firmly  closed  and  therefore  secondary  hemorrhage  should 
occur.  These  experiments  upon  animals  have  been  at- 
tended with  but  little  pain,  and  in  many  cases  practically 
none,  for  they,  too,  have  been  done  antiseptically.  The 
results  shown  above  attest  the  immense  value  of  the  investi- 
gations. Yet  the  antivivisection  laws  in  England  are  so 
hostile  to  all  humane  progress  in  surgery  that  when,  a  few 
years  since.  Lister  desired  to  carry  on  some  experiments 
with  a  view  to  still  greater  perfection,  he  was  obliged  to 
leave  London  and  go  to  France  in  order  to  perform  them. 
After  experimenting  in  animals  with  ligatures,  with 
sutures,  and  with  disinfectants  in  the  various  modes  of 
the  antiseptic  treatment  of  wounds,  then  followed  the 
crucial  test  in  man — a  test  only  justified  by  the  good 
results  first  obtained  in  animals.  These  trials  have  from 
time  to  time  been  followed  by  modifications  in  detail,  but 
practically  none  in  principle. 

Secondly,  this  result  has  been  attained  by  a  painstaking 
study  of  the  entire  life-history  of  the  many  varieties  of 
microbes  or  bacteria  now  known  to  exist:  what  distinguishes 
one  from  another,  and  what  favors  and  what  hinders  the 
development  of  each.  Next  the  effects  of  their  intentional 
inoculation  in  animals  were  observed;  and  then  the  results 


AND  MEDICAL  PROGRESS  29 

of  their  occurrence  in  man  in  various  diseases  and  accidents. 
In  fact,  this  study  of  bacteria  is  now  a  distinct  science, 
known  as  bacteriology,  and  has  among  its  students  some 
of  the  most  noted  names  in  medicine.  One  of  the  practical 
results  of  such  scientific  study  of  bacteriology  is  seen  in  the 
recent  immense  improvement  of  our  treatment  of  that 
dangerous  accident  already  alluded  to — compound  frac- 
tures. The  statistics  of  compound  fractures  from  a  half- 
dozen  of  the  best  hospitals  of  America  and  Europe  for 
varying  periods  from  twelve  to  twenty  years  before  the 
introduction  of  antiseptic  methods  gave  a  mortality  vary- 
ing from  26  to  68  per  cent,  the  majority  of  deaths  being 
from  serious  complications  due  to  blood-poisoning.  The 
introduction  of  antiseptics  caused  a  falling-off  of  the  death- 
rate  of  Billroth's  cases  in  Vienna  to  one  tenth  of  what  it 
formerly  was,  and  in  the  other  hospitals  in  similar  though 
varying  proportions.  Still  more  remarkable  are  the  results 
recently  reported  by  Dennis  of  New  York.  Of  446  com- 
pound fractures  of  all  grades,  from  the  most  severe  down, 
of  which  385  belonged  to  the  class  of  severe  fractures,  only 
2  died,  the  mortality  being  less  than  one  half  of  one  per  cent 
—  less  than  2  in  400  in  contrast  to  the  rate  previous  to  the 
introduction  of  modern  surgical  methods  of  from  104  up  to 
272  in  400!  At  present  his  list  of  cases  extends  to  about 
900  without  a  single  death  from  blood-poisoning.  Nothing 
can  add  force  to  such  a  statement. 

Besides  these  very  remarkable  results  in  the  almost 
certain  and  painless  heahng  of  severe  accidents  and  of 
operation  wounds  within  the  last  few  years,  as  a  result  of 
the  scientific  studies  just  noted,  many  other  achievements 
have  been  made  possible  by  them  in  modern  surgery,  to 
which  I  must  now  allude. 

The  two  regions  of  the  body  in  which  the  most  marvelous 
advance  has  been  made  are  the  abdomen  and  the  head. 
Twenty -five  years  ago,  to  open  the  cavity  of  the  abdomen 
and  explore  the  peritoneum  (a  thin  membrane  which  lines 


80  ANIMAL  EXPERIMENTATION 

the  entire  cavity  and  covers  all  its  contents)  was  a  step 
from  which  every  prudent  surgeon  shrunk.  If  it  were 
opened  by  accident,  there  was  nothing  left  for  us  but  to  do 
the  best  we  could,  and  usually  the  best  meant,  in  the 
absence  of  antiseptic  methods,  to  look  on  until  the  patient 
died,  helpless  to  do  aught  except  administer  a  few  anodynes 
until  death  came  to  his  relief. 

During  the  War  of  the  Rebellion  there  were  64  cases  of 
wounds  of  the  stomach,  and  only  1  recovered.  Otis  esti- 
mated the  mortality  at  99  per  cent.  In  over  650  cases  of 
wounds  of  the  intestines  there  are  recorded  in  the  literature 
of  the  war  only  5  cases  of  recovery  from  wounds  of  the 
small  intestine  (and  there  is  even  some  doubt  as  to 
whether  the  intestine  was  really  wounded  in  these  5) 
and  59  from  wounds  of  the  large  intestine.  A  gunshot 
wound  in  the  abdomen  was  looked  upon  as  almost 
necessarily  fatal.  Surgeons  scarcely  dared  to  open  the 
abdomen  either  to  search  for  the  ball,  to  close  a  fatal 
perforation  of  the  bowels,  or  to  check  hemorrhage. 

America  can  rightly  boast  of  playing  the  chief  role  in 
effecting  the  change  that  has  taken  place.  The  elder  Gross 
long  since  led  the  way  by  his  experiments  on  dogs,  but  we 
owe  our  present  boldness  and  success  chiefly  to  the  experi- 
ments of  Parkes,  Bull,  and  Senn,  —  all  Americans,  —  who 
have  first  shown  in  animals  that  it  was  safe  and  right,  with 
antiseptic  methods,  to  interfere  actively  for  the  health  and 
healing  of  our  patients.  While  it  is  true  that  a  small  rear- 
guard in  the  surgical  army  would  fold  their  hands  and  give 
opium  until  the  patient  died,  there  is  scarcely  a  man  abreast 
with  modern  ideas  who  in  such  a  case  would  not  open  the 
abdomen,  tie  bleeding  vessels,  sew  up  a  rupture  or  wound 
of  the  stomach  or  bowels,  remove  a  lacerated  kidney,  and 
in  general  repair  any  damage  done.  Of  course,  large  num- 
bers of  such  patients,  either  from  immediate  hemorrhage, 
or  from  the  severity  of  the  wound  inflicted,  must  always 
die.   But,  to  say  nothing  of  the  numerous  other  cases  in 


AND  MEDICAL  PROGRESS  31 

which  recovery  has  followed  operative  interference  in  such 
wounds,  even  though  multiple,  the  possibilities  of  modern 
surgery  are  well  shown  in  a  case  reported  by  Senn,  in  which 
eleven  perforations  of  the  bowel  were  sewed  up,  and  another 
case  of  Hamilton's  in  which  there  was  so  extraordinary  a 
number  as  thirteen  wounds  of  the  intestines,  besides  wounds 
of  the  omentum  and  the  mesentery,  and  yet  both  of  these 
patients  made  uninterrupted  recoveries !  In  a  recent  table 
by  Morton  of  19  cases  of  stab  wounds  (all,  of  course,  by 
dirty  knives,  and  one  even  by  a  ragged  splinter  of  dirty 
wood)  with  hemorrhage  and  protrusion  of  the  bowels,  12 
recovered  and  but  7  died,  and  even  of  110  gunshot  wounds 
of  the  intestines  in  which  the  abdomen  was  opened,  36  lives 
were  saved.  ^ 

If  this  be  the  admirable  showing  in  wounds  attended  by 
infection  from  dirty  knives,  from  the  dirt  on  the  clothing, 
and  from  the  ground  on  which  wounded  persons  would  fall, 
it  is  no  wonder  that,  with  clean  hands  and  instruments, 
surgeons  have  dared  not  only  to  open  the  abdominal  cavity 
to  verify  a  probable  diagnosis,  or  to  perform  an  operation, 
but  to  go  still  farther  and  to  open  the  abdomen  to  make  a 
diagnosis.  It  is  often  impossible  to  make  an  absolute  diag- 
nosis from  external  examination  alone,  not  only  on  account 
of  the  inherent  difficulty  from  the  close  grouping  of  so  many 
organs  within  the  abdominal  cavity,  but  even  in  cases 
apparently  not  obscure  we  may  be  in  error.  At  the  present 
day  it  is  not  only  considered  justifiable  and  not  unreason- 
ably dangerous  to  open  the  abdomen  for  the  removal  of 
tumors  that  are  clearly  fit  for  operation,  but  in  a  very  large 
number  of  doubtful  cases  it  is  the  duty  of  the  surgeon  to 
make  a  small  opening  directly  into  the  abdominal  cavity, 
and  to  insert  two  fingers  in  order  to  determine  by  touch 
what  the  nature  of  the  tumor  or  other  disorder  is,  and, 

*  Keyes,  Journal  American  Medical  Association,  November  23,  1912; 
p.  1886,  records  a  recovery  after  twenty-two  gunshot  perforations  of  the 
bowel! 


82  ANIMAL  EXPERIMENTATION 

having  determined  its  nature,  to  proceed  to  its  removal,  if 
the  facts  warrant  it;  if  not,  the  abdominal  wound  is  closed, 
and  the  patient  practically  always  recovers  from  the 
incision.  So  slight  is  the  danger  from  such  "exploratory 
operations,"  as  they  are  rightly  called,  that  it  is  not  to  be 
weighed  for  a  moment  against  the  advantages  derived  from 
positive  knowledge. 

The  most  remarkable  statistics  recently  published  are 
those  of  Mr.  Tait,  and  a  mere  statement  of  his  percentages 
will  go  far  to  convince  the  non-medical  public  of  the  correct- 
ness of  the  above  statements,  startling  as  they  appear  to 
one  unfamiUar  with  modern  surgical  progress.  Mr.  Tait  has 
completed  a  second  series  of  1000  cases  in  which  he  opened 
the  abdomen  for  the  removal  of  tumors,  for  abscesses,  for 
exploration,  etc.  In  his  first  1000  cases  only  92  patients 
died  (9.2  per  cent),  and  in  the  second  1000  only  53  died 
(5.3  per  cent) .  In  ovariotomy  alone  the  percentage  fell  from 
8.1  in  the  first  1000  to  3.3  in  the  second.  Only  a  quarter 
of  a  century  ago  the  mortality  of  ovariotomy  was  but  little, 
if  at  all,  under  50  per  cent.  I  have  heard  the  first  obstetri- 
cian of  his  day,  when  I  was  a  student,  say  that  any  man 
who  dared  to  open  the  abdomen  to  remove  an  ovarian 
tumor  should  be  indicted  for  murder!  Sir  Spencer  Wells, 
even  with  the  far  larger  mortality  of  his  earher  days,  added 
twenty  thousand  years  to  human  life  as  the  net  result  of 
one  thousand  ovariotomies!  He  has  lived  to  see  even  his 
great  success  far  surpassed  by  the  best  surgeons;  and  all 
over  the  civilized  world,  even  the  average  surgeon  is  fol- 
lowed by  benedictions  for  recovery  in  ninety  out  of  every 
hundred  of  such  operations. 

Surgeons  have  even  successfully  removed  tumors  that 
after  removal  weighed  more  than  all  the  rest  of  the 
patient's  body.  But  we  go  further  than  the  mere  removal 
of  abdominal  tumors.  In  a  considerable  number  of  cases  of 
cancer  of  the  stomach  the  diseased  part  of  the  stomach 
itself  has  been  removed,  and  the  patient  has  made  a  good 


AND  MEDICAL  PROGRESS  33 

recovery.  Of  course,  however,  the  disease  often  returns, 
and  is  eventually  fatal.  In  cases  of  cancer  and  obstruction 
of  the  bowels,  or  of  extensive  wounds,  even  three  or  four 
feet  of  the  bowel  have  been  completely  removed,  the  ends 
sewed  together,  and  the  patients  have  recovered.  In  other 
cases,  instead  of  removing  the  diseased  parts,  openings 
have  been  made  in  the  bowel,  one  above  and  one  below 
the  disease,  the  two  openings  being  then  placed  opposite 
each  other  and  united  by  their  margins,  and  the  continuity 
of  the  bowel  has  been  thus  successfully  reestablished,  the 
intestinal  contents  following  the  "  short-cut "  thus  provided. 
This  very  new  operation  has  only  been  done  in  man  in  a 
very  small  number  of  cases,  but  the  mortality  in  dogs  is  only 
7.69  per  cent,  and  as  our  procedure  will  improve  by  experi- 
ence, it  will  probably  be  even  less  in  the  human  subject. 

When  the  spleen  is  enlarged,  it  also  has  been  successfully 
removed  in  90  cases,  followed  by  51  recoveries.  Occasion- 
ally the  spleen,  instead  of  being  fixed  in  its  place,  is  loose 
or  "floating"  in  the  abdominal  cavity.  In  10  cases  these 
have  been  removed,  with  8  recoveries. 

Another  remarkable  achievement  of  abdominal  surgery 
is  in  operations  on  the  gall-bladder.  Occasionally  a  number 
of  gall-stones^  are  formed  in  the  gall-bladder  or  its  duct  and 
produce  dangerous  and  often  fatal  disease.  In  78  cases 
now  recorded  the  gall-bladder  has  been  opened,  the  gall- 
stones removed,  and  64  of  the  patients  have  recovered. 
Not  satisfied  even  with  this,  in  22  cases  the  entire  gall- 
bladder itself  has  been  removed  to  prevent  any  recurrence 
of  the  disease,  and  19  of  the  patients  have  demonstrated 
the  fact  that  they  could  get  along  quite  as  well  without 
such  an  apparently  useless  appendage  as  with  it;  in  fact, 
in  their  cases  at  least,  a  good  deal  better.  In  100  operations, 
therefore,  on  the  gall-bladder  the  mortality  has  been  only 

*  These  stones  arise  from  the  bile,  and  are  often  as  large  as  marbles. 
Sometimes  only  one  exists,  but  sometimes  there  are  even  hundreds  of 
them. 


S4  ANIMAL  EXPERIMENTATION 

17  per  cent.  Mr.  Tait  himself  has  performed  54  such  opera- 
tions, and  has  lost  but  2  patients,  a  mortality  of  less  than 
4  per  cent.  Considerable  portions  of  the  liver  have  also 
been  removed  with  success,  one  of  the  operations  being 
necessitated  as  a  direct  result  of  the  use  of  corsets,  in  the 
opinion  of  the  operator.^ 

Operations  on  the  kidney  are  among  the  most  remarkable 
triumphs  of  abdominal  surgery.  In  1869  Simon,  of  Heidel- 
berg, had  a  patient  suffering  from  various  troubles  with  the 
duct  of  the  kidney.  After  many  experiments  on  dogs  to 
determine  whether  it  was  possible  for  them  to  live  with  one 
kidney,  after  the  sudden  removal  of  its  fellow,  he  ventured 
to  remove  this  otherwise  healthy  organ,  and  the  patient 
lived  for  eight  years  in  perfect  health.^  Since  then  very 
many  such  operations  have  been  done,  and  the  latest  results 
are  as  follows:  In  375  cases  of  entire  removal  of  one  kidney 
in  consequence  of  its  being  hopelessly  diseased,  197  lives 
were  saved.  In  95  cases  of  abscesses  and  other  diseases, 
in  which  the  kidney  was  cut  down  upon  in  the  loin  or  abdo- 
men, and  the  kidney  opened  and  drained,  76  lives  were 
saved.  In  102  cases  in  which  stones  were  removed  from  the 
kidney,  76  lives  were  saved,  and  in  25  cases  in  which  the 
kidney  (as  in  the  case  of  the  spleen  above  referred  to)  was 
"floating"  around  loose  in  the  abdomen,  and  a  source  of 
discomfort  and  pain,  it  had  been  cut  down  upon,  sewed 
fast  in  its  proper  place,  and  all  but  one  got  well,  and  even 
this  one  death  was  from  injudicious  surgery.  A  total  of 
597  operations  on  the  kidney  shows,  therefore,  recovery 
and,  in  general,  complete  restoration  to  health  in  373.  Had 
the  patients  been  let  alone  (as  they  would  have  been  prior 
to  Simon's  experiments  in  1869),  almost  every  one  would 
have  diedy  and  that,  too,  after  weeks,  or  years  it  might  be, 
of  horrible  pain  and  loathsome  disease. 

*  The  statistics  of  all  these  operations  have  been  greatly  bettered 
in  the  twenty-five  years  since  this  was  written.  (1914.) 
2  See  pp.  10-12. 


AND  MEDICAL  PROGRESS  35 

But  the  most  extraordinary  achievement  of  modern  sur- 
gery remains  to  be  told.  In  the  "Lancet"  for  December 
20,  1884,  Dr.  Bennett  and  Mr.  (later  Sir  Rickman  J.) 
Godlee  published  an  article  which  startled  the  surgical 
world.  Dr.  Bennett  had  diagnosticated  not  only  the 
existence,  but  the  exact  locality  of  a  tumor  in  the  brain, 
of  which  not  the  least  visible  evidence  existed  on  the  exte- 
rior of  the  skull,  and  asked  Godlee  to  attempt  its  removal. 
The  head  was  opened  and  the  brain  exposed.  No  tumor 
was  seen,  but  so  certain  were  they  of  the  diagnosis  that 
Godlee  boldly  cut  open  the  healthy  brain  and  discovered 
the  tumor  the  size  of  a  walnut  and  removed  it.  After  doing 
well  for  three  weeks,  inflammation  set  in,  and  the  patient 
died  on  the  thirty-eighth  day.  But,  like  the  failure  of  the 
first  Atlantic  cable,  it  pointed  the  way  to  success,  and  now 
there  have  been  twenty  tumors  removed  from  the  brain,  of 
which  seventeen  have  been  removed  from  the  cerebrum 
with  thirteen  recoveries,  and  three  from  the  more  dangerous 
region  of  the  cerebellum,  all  of  which  proved  fatal.  Until 
this  recent  innovation  every  case  of  tumor  of  the  brain  was 
absolutely  hopeless.  The  size  of  the  tumors  successfully 
removed  has  added  to  the  astonishment  with  which 
surgeons  view  the  fact  of  their  ability  to  remove  them  at 
all.  Tumors  measuring  as  much  as  three  and  four  inches 
in  diameter  and  weighing  from  a  quarter  to  over  a  third 
of  a  pound  have  been  removed  and  the  patients  have  re- 
covered. 

Another  disease  formerly  almost  invariably  fatal  is 
abscess  of  the  brain.  In  the  majority  of  cases  this  comes 
as  a  result  of  long-standing  disease  of  the  ear,  which  after  a 
while,  involves  the  bone  and  finally  the  brain.  So  long  ago 
as  1879  Dr.  (later  Sir  William)  Macewen,  of  Glasgow,  diag- 
nosticated an  abscess  in  the  brain,  and  wished  to  operate 
upon  it.  The  parents  declined  the  operation,  and  the  pa- 
tient died.  After  death  Macewen  operated  precisely  as  he 
would  have  done  during  life,  found  the  abscess  and  evacu- 


S6  ANIMAL  EXPERIMENTATION 

ated  the  pus,  thus  showing  how  he  could  probably  have 
saved  the  child's  life.  Since  then  the  cases  treated  in  such 
a  manner  amount  to  scores,  and  more  than  half  of  them 
have  recovered  without  a  bad  symptom. 

In  injuries  of  the  skull  involving  the  brain,  the  larger 
arteries  are  sometimes  wounded,  and  the  blood  that  is 
poured  out  between  the  skull  and  the  brain  produces  such 
pressure  as  to  be  speedily  fatal.  In  some  cases,  even  without 
any  wound,  the  larger  arteries  are  ruptured  by  a  blow  or 
fall,  and  a  similar  result  follows  the  hemorrhage.  Nowa- 
days, in  both  of  these  injuries,  any  well-instructed  surgeon 
will  open  the  head,  secure  the  bleeding  vessel,  and  turn  out 
the  clot  with  a  good  chance  of  recovery  in  a  large  number  of 
cases.  Even  gunshot  wounds  of  the  brain  are  no  longer 
necessarily  fatal.  Among  a  number  of  other  successful 
cases  one  has  been  recently  reported  in  which  the  ball  went 
all  the  way  from  the  forehead  to  the  back  of  the  head,  and 
after  striking  the  bone  rebounded  into  the  brain.  The  back 
of  the  skull  was  opened,  the  ball  removed,  and  a  rubber 
drainage  tube  of  the  caliber  of  a  lead  pencil  passed  in  the 
track  of  the  ball  completely  through  the  head,  and  the 
patient  recovered.  So  httle  danger  now  attaches  to  opening 
the  skull,  with  antiseptic  precautions  similar  to  those 
already  described,  that  the  latest  writer  on  trephining 
(Seydel)  estimates  that  trephining  per  se  is  fatal  only  in 
1 .6  per  cent  of  the  cases.  Mr.  (later  Sir  Victor)  Horsley  has 
recently  published  a  most  remarkable  paper,  including  ten 
operations  on  the  brain,  in  which,  without  anything  on  the 
exterior  to  indicate  its  situation,  the  site  of  the  disease  was 
correctly  located  in  all,  and  nine  of  them  recovered  after 
operation. 

Almost  equally  astonishing  are  the  results  of  brain 
surgery  in  certain  cases  of  epilepsy;  for  the  surgical  treat- 
ment of  the  cases  justifying  such  interference  has  been 
attended  with  the  most  brilliant  results.  In  these  cases  the 
spasm  begins  in  a  particular  part  of  the  body;  for  example. 


AND  MEDICAL  PROGRESS  37 

the  hand  or  the  thumb,  or  it  is  limited  to  one  arm,  or  to  one 
side  of  the  body.  Some  of  them  have  been  operated  upon 
without  any  benefit,  but  a  large  number  of  other  cases  have 
been  operated  on  and  either  benefited  or,  in  not  a  few  cases, 
have  been  completely  restored  to  health.  That  the  words 
"brilliant  results'*  are  not  inappropriate  will  certainly  be 
granted  when  we  look  at  Horsley*s  table  of  cases.  One 
patient  had  2870  epileptic  convulsions  in  thirteen  days, 
and  completely  recovered,  not  only  from  the  operation, 
but  also  from  his  terrible  malady,  after  the  removal  of  a 
diseased  portion  of  the  brain,  the  result  of  an  old  depressed 
fracture  of  the  skull.  Besides  this,  a  few  cases  of  headache 
so  inveterate  as  to  make  ordinary  occupations  impossible 
and  life  itself  a  burden  have  been  cured  by  trephining  the 
skull.  Even  insanity  itself  has  been  cured  by  such  an  opera- 
tion in  cases  in  which  it  has  followed  injuries  to  the  head. 
What  the  ultimate  result  of  these  recently  inaugurated 
operations  will  be  it  is  impossible  to  tell  as  yet,  but  thus 
far  they  have  been  so  beneficent  and  so  wonderful  as  to 
arouse  not  only  our  greatest  astonishment,  but  also  our 
most  sanguine  hopes.  ^ 

The  question  will  naturally  arise,  how  is  it  that  the  neu- 
rologists can  determine  so  exactly  the  location  of  such  tum- 
ors, abscesses,  hemorrhages,  scars,  and  other  alterations 
of  tissue  giving  rise  to  epilepsy  and  other  disorders  men- 
tioned, without  the  slightest  indication  on  the  exterior  of 
the  skull  to  point  to  the  diseased  spot.  That  this  is  of 
supreme  importance  in  the  brain  will  be  evident  upon  a 
moment's  reflection.  In  other  parts  of  the  body,  even  if  we 
make  an  error  of  an  inch  or  two,  it  is  of  comparatively 
little  importance,  as  the  incision  can  be  easily  prolonged, 
and  heals  readily.  But  in  the  skull,  from  the  very  nature  of 
the  bony  envelope,  an  error  of  an  inch  or  two  means  almost 

*  Larger  and  longer  experience  has  modified  these  expectations.  Most 
cases  of  epilepsy  are  not  amenable  to  operation,  but  in  many  cases  the 
result  has  been  "brilliant."  (1914.) 


38  ANIMAL  EXPERIMENTATION 

certain  failure  to  find  the  disease,  and  means,  therefore, 
possibly  the  death  of  the  patient. 

It  is  impossible  within  the  limit  of  this  paper  to  state  in 
detail  the  method,  but  the  following  brief  sketch  may  give 
some  idea  of  it.  Whatever  can  be  advanced  against  vivi- 
section, there  is  this  to  be  said  in  its  favor,  that  without  it 
the  exact  localization  of  cerebral  tumors  and  other  such 
lesions,  which  is  one  of  the  chief  glories  of  the  present  day, 
would  be  impossible.  We  owe  our  knowledge  of  the  loca- 
tion of  cerebral  functions  to  many  observers,  chief  of  whom 
are  Ferrier  and  Horsley,  of  England,  and  Fritsch,  Hitzig, 
and  Goltz,  of  Germany.  Horsley*s  method  will  suffice  as  a 
type. 

The  brain  of  a  monkey  having  been  exposed  at  the  part 
to  be  investigated,  the  poles  of  a  battery  are  applied  over 
squares  one  tweKth  of  an  inch  in  diameter,  and  all  the  vari- 
ous movements  which  occur  (if  any)  are  minutely  studied. 
One  square  having  been  studied,  the  next  is  stimulated, 
and  the  results  are  again  noted,  and  so  on  from  square  to 
square.  These  movements  are  then  tabulated.  For  exam- 
ple, all  those  adjacent  squares  which,  when  stimulated, 
produce  movements  of  the  thumb  are  called  the  region  for 
representation  of  the  thumb,  or,  shortly,  "the  thumb 
center  " ;  and  to  all  those  squares  which  produce  movements 
of  the  hand,  the  elbow,  the  shoulder,  or  the  face,  etc.,  are 
given  corresponding  names.  In  this  way  the  brain  has 
been  mapped  out,  region  by  region,  and  the  same  minute, 
patient  study  given  to  each. 

These  animals,  I  should  add,  are  etherized  so  that  they 
do  not  suJBPer  the  least  pain.  I  may  also  say  in  passing  that 
such  operations^  with  few  exceptions,  even  without  ether, 
are  not  painful.   The  brain  itself  can  be  handled,  com- 

*  Operations  on  the  brain  itself  were  meant.  Of  course  the  incision  in 
the  scalp  would  be  very  painful  and  would  require  an  anesthetic.  Hand- 
ling, cutting,  and  even  burning  the  brain  tissue  (as  is  occasionally  neces- 
sary to  check  hemorrhage),  it  must  be  emphasized  produces  not  the  least 
'pain.  I  have  had  patients  chat  and  joke  with  me  while  doing  so.  (1914.) 


AND  MEDICAL  PROGRESS  39 

pressed,  cut,  or  torn  without  the  least  pain.  A  number  of 
cases  have  already  been  reported  in  which  a  considerable 
portion  of  the  human  brain  has  been  removed  by  operation 
and  the  patients  have  been  out  on  the  street  within  a  week, 
without  pain,  fever,  or  a  single  dose  of  medicine. 

Studying  in  this  way  the  brain  of  the  lower  animals,  we 
now  have  a  very  fair  knowledge  of  the  localization  of  many 
of  its  functions.  With  the  functions  of  the  front  part  we 
are  as  yet  not  familiar.  The  part  which  lies,  roughly  speak- 
ing, behind  and  in  front  of  one  of  the  chief  fissures  of  the 
brain  (the  fissure  of  Rolando),  which  runs  downward  and 
forward  above  the  ear,  is  known  as  the  "motor  region."  In 
this  region  the  different  centers  have  been  mapped  out  in 
the  monkey's  brain,  and  have  been  verified  in  the  brain  of 
man  many  times.  Most  of  that  part  of  the  brain  above  and 
behind  the  ear  has  no  special  functions  that  we  know  of  at 
present,  except  one  region,  which  is  the  center  for  sight. 
Injury  to  this  produces  blindness  of  the  half  of  each  retina 
on  the  same  side  as  the  injury  to  the  brain.  But  it  is  ex- 
tremely diflficult  to  obtain  in  the  lower  animals  any  evi- 
dence of  the  special  senses  other  than  that  of  touch,  the 
abolition  of  which  produces  loss  of  feeling,  of  which  we  can 
get  exact  evidence.  Motion  and  sensation,  therefore,  are 
the  two  things  that  can  be  most  readily  determined. 

Having  now  ascertained  in  animals  the  location  of  the 
particular  centers,  the  next  step  is  to  apply  this  knowledge 
to  the  human  brain  in  judging  of  the  processes  of  disease. 
But  it  will  be  easily  seen  that  the  experiments  that  disease 
performs  in  a  human  brain  are  clumsy,  spread  over  a  wide 
area,  and  therefore  often  diflicult  of  interpretation.  In- 
stances affecting  a  single  little  area  of  brain  surface  one 
tweffth  of  an  inch  in  diameter  are  almost  unknown,  and  a 
tumor  has  been  removed  of  such  size  that  it  produced  direct 
pressure  upon  more  than  twelve  hundred  such  squares,  and 
indirectly  produced  pressure  upon  many  distant  parts  of 
the  brain.  This  is,  of  course,  very  clumsy  experimentation. 


40  ANIMAL  EXPERIMENTATION 

The  familiar  game  of  "shouting  proverbs"  will  well  illus- 
trate the  difficulty  of  interpreting  the  answers  of  disease 
to  our  question,  "Where  is  it  located?"  Imagine  twelve 
hundred  persons,  each  assigned  a  single  word  of  a  proverb 
of  twelve  hundred  words.  At  a  given  signal  each  shouts 
his  own  word.  What  a  Babel  of  sound!  How  utterly  im- 
possible of  disentanglement  and  proper  arrangement!  This 
is  the  answer  of  disease  as  represented  by  such  a  tumor. 
Take  each  of  the  twelve  hundred  persons  in  the  proper 
order  and  question  him  separately  and  repeatedly,  write 
down  the  answers  accurately  and  in  their  proper  sequence, 
and  behold  the  proverb!  This  is  the  answer  of  scientific 
investigation  as  seen  in  vivisection. 

Instead  of  there  being  a  tumor,  a  blood-vessel  will  some- 
times break  in  the  brain,  and  produce  a  clot,  affecting  sim- 
ilarly a  large  area;  or  softening  of  the  brain  will  in  the  same 
way  invade  an  equal  or  a  greater  number  of  centers.  It  is 
therefore  extremely  rare  that  we  can  find  a  small  area,  such 
as  that  for  speech,  or  for  the  hand,  or  for  the  arm,  or  for 
the  face,  or  for  the  leg,  or  for  sight,  that  is  involved  entirely 
by  itself.  But  such  cases  do  occasionally  occur,  and  they 
are  extremely  valuable  in  fortifying  the  conclusions 
derived  from  the  exact  experiments  of  the  laboratory. 
While  some  of  the  cases  have  introduced  confusion  and 
uncertainty  from  the  character  of  nature's  experiments, 
it  can  be  broadly  asserted  that  generally  they  have  abso- 
lutely confirmed  them.  The  results  obtained  by  the  surgery 
of  the  brain  have  more  than  confirmed  them;  for,  as  indi- 
cated already,  the  brain  has  been  exposed,  and  that  portion 
which,  according  to  experiment,  is  believed  to  be  the  center 
for  the  wrist,  or  for  the  shoulder,  etc.,  has  been  cut  out, 
and  paralysis  of  the  corresponding  part  (a  paralysis  which, 
however,  is  usually  only  temporary)  has  proved  positively 
the  accuracy  of  the  inference  from  animals. 

We  are  still  a  little  uncertain  as  to  the  exact  functions  of 
large  portions  of  the  brain,  but  we  have  made  a  reasonable 


AND  MEDICAL  PROGRESS  41 

beginning;  we  have  found  firm  ground  to  stand  upon,  and 
the  results  already  obtained  in  the  relief  of  human  suffering 
and  the  cure  of  disease  are  such  as  readily  encourage  the 
hope  that  in  the  near  future  we  shall  be  able  to  do  vastly 
more.  The  opponents  of  vivisection  have  stoutly  contended 
that  it  has  shown  no  useful  results.  Let  us  wholly  ignore 
the  researches  of  Sir  Charles  Bell,  of  Harvey  or  Hunter,  or 
other  experimenters  of  the  past.  Here  is  a  field  in  which  the 
last  ten  years  have  opened  wholly  new  ground  for  modern 
surgery,  in  which  already  the  operations  of  the  last  four 
years  have  been  marvelously  successful,  and  have  startled 
even  surgeons  themselves.  Had  vivisection  done  nothing 
else  than  this,  it  would  be  amply  justified,  and  to  obstruct 
researches  so  rich  in  beneficent  results  would  be  a  disaster 
to  humanity. 

But  not  only  has  the  brain  been  exposed  and  compelled 
to  give  up  its  secrets,  and  to  yield  itself  to  the  successful 
assaults  of  the  surgeon,  —  the  spine  has  also  of  late  been 
the  field  of  some  remarkable  work.  About  a  year  ago 
Horsley  reported  a  remarkable  case,  in  which  a  tumor  by 
pressure  on  the  spinal  cord  had  been  the  source  of  most 
frightful  pain  for  a  long  time,  and  of  paralysis  of  all  the 
lower  half  of  the  body.  Once  that  an  accurate  diagnosis, 
not  only  of  its  existence,  but  of  its  actual  locality  was  made, 
he  made  an  incision  in  the  back,  exposing  the  backbone, 
cut  away  the  bone  down  to  the  membrane,  and  even  to  the 
spinal  marrow  itseK,  and  removed  the  tumor.  When  last 
reported  the  patient  was  able  to  walk  three  miles,  and  even 
to  dance.  Since  then  there  have  been  numerous  successful 
operations  upon  the  spine  in  this  country,  in  England,  and 
in  France,  and  the  near  future  will  doubtless  show  even 
better  results.  Already  severe  fractures  of  the  spine  have 
been  operated  upon  by  removal  of  the  fragments  sticking 
into  the  spinal  marrow,  and  recovery  has  followed  instead 
of  a  lingering  and  certain  death. 

We  are  only  just  beginning  to  interfere  surgically  with 


42  ANIMAL  EXPERIMENTATION 

the  lungs;  to  open  abscesses  in  them,  and  to  remove  por- 
tions successfully;  and  several  ribs  have  been  removed  in 
cases  of  chronic  pleurisy  and  deformed  chests. 

Formerly  one  of  the  most  dangerous  operations  known 
was  the  removal  of  goiters.  Hemorrhage,  inflammation, 
and  blood-poisoning  destroyed  a  very  large  number  of  such 
cases,  and  when  Kocher,  of  Berne,  in  1882,  reported  58 
operations,  with  a  mortality  of  only  14.3  per  cent,  it  was 
deemed  a  triumph.  But  improved  methods  of  operation 
reduced  the  mortaHty  until,  in  1884,  he  reported  43  more 
operations,  with  a  mortaUty  of  only  6.9  per  cent,  and  in 
1889  he  has  just  reported  250  additional  operations,  and  all 
but  6  patients  recovered —  a  mortality  of  but  2.4  per  cent, 
or,  if  we  exclude  the  25  cases  of  cancer,  which  gave  4  of  the 
deaths,  we  have  225  cases  and  only  2  deaths,  a  mortaUty 
of  but  0.8  per  cent.^ 

We  see  few  cases  of  severe  knock-knee  and  bowlegs  in 
this  country,  but  among  the  ill-fed  lower  classes  of  Europe 
they  are  common.  Formerly  almost  nothing  could  be  done; 
but  a  few  years  ago  surgeons  began  to  operate  upon  them 
in  this  way:  A  small  cut  is  made  through  the  skin  and  mus- 
cles down  to  the  bone,  and  by  a  saw  or  a  chisel  the  bone 
is  divided.  The  limb  is  then  straightened,  and  the  case 
treated  precisely  as  if  it  were  an  ordinary  fracture.  It 
heals  without  fever  or  serious  pain,  and  the  patient  is  well. 
With  modern  methods  this  is  not  a  dangerous  operation, 
as  will  be  seen  by  the  remarkable  paper  read  by  Macewen, 
of  Glasgow,  at  the  International  Medical  Congress  of  1884, 
in  Copenhagen,  when  he  reported  1800  operations  on  1267 
limbs  in  704  patients,  and  only  5  died,  in  spite  of  the  fact, 
too,  that  most  of  them,  from  deformity  in  several  Hmbs, 
had  to  have  multiple  operations.  Even  these  deaths  were 

1  Charles  H.  Mayo,  in  1913,  reported  five  thousand  cases  (including 
all  varieties)  of  goiter  operated  on  in  the  Mayo  clinic  in  twenty-five 
years,  with  a  mortality  of  only  one  to  three  per  cent.  (Journal  of  the 
American  Medical  Association,  July  5,  1913.) 


AND  MEDICAL  PROGRESS  43 

not  due  to  the  operation,  but  followed  from  pneumonia, 
typhoid  fever,  consumption,  and  diphtheria. 

We  have  learned,  too,  that  portions  of  the  body  can  be 
entirely  severed,  and,  if  suitably  preserved,  can  be  replaced, 
and  they  will  adhere  and  grow  as  if  nothing  had  happened. 
When  a  wound  is  slow  in  heahng,  we  now  take  bits  of  skin, 
either  from  the  patient's  own  body  or  provided  by  generous 
friends,  or  even  from  frogs,  and  "graft"  them  on  the  sur- 
face of  the  wound.  They  usually  adhere,  and  as  they 
enlarge  at  their  margins,  they  abridge  by  one-half  the  time 
required  for  healing.  Even  a  large  disk  of  bone,  one  or  two 
inches  in  diameter,  when  removed  from  the  skull,  can  be  so 
treated.  It  is  placed  in  a  cup  filled  with  a  warm,  antiseptic 
solution.  This  cup  is  placed  in  a  basin  of  warm  water,  and 
it  is  the  duty  of  one  assistant  to  see  that  the  thermometer 
in  this  basin  shall  always  mark  100°  to  105°  F.  The  bone 
may  be  separated  from  the  skull  so  long  as  one  or  two  hours, 
but,  if  properly  cared  for,  can  be  replaced,  and  will  grow 
fast  and  fulfill  its  accustomed,  but  interrupted,  duty  of 
protecting  the  brain. ^ 

The  remarkable  progress  of  surgery  which  I  have  so  im- 
perfectly sketched  above  has  been,  as  I  have  shown,  the 
result  chiefly  of  experimental  laboratory  work.  To  Mr. 
Carnegie,  of  New  York,  is  due  the  credit  of  establishing  the 
first  bacteriological  laboratory  in  this  country,  and  from 
studies  in  this  laboratory  arose  the  brilliant  and  beneficent 
results  in  the  treatment  of  compound  fractures  which  I 
have  quoted.  If  one  laboratory  can  give  such  beneficent 
results  in  one  single  surgical  accident,  what  will  not  many 
do,  each  vieing  with  all  the  rest  in  investigating  different 
important  surgical  and  medical  questions  as  yet  unsolved? 
Could  wealthy  private  citizens  erect  more  useful  monu- 

'  Carrel's  extraordinary  success  in  transplanting  tissues  even  after 
being  for  days  in  "cold  storage," his  successful  transplantations  of  the 
entire  kidney  and  an  entire  leg  in  animals,  are  among  the  latest  achieve- 
ments of  surgery.   (1914.) 


44  ANIMAL  EXPERIMENTATION 

ments  of  enduring  fame?  In  Europe  the  government  es- 
tablishes and  supports  such  laboratories.  In  America  we 
must  look  to  private  munificence,  and  never  yet  has  hu- 
manity made  such  an  appeal  to  my  countrymen  in  vain. 


VIVISECTION  AND  BRAIN-SURGERY  ^ 

To  "Harper's  Magazine"  for  October,  1889,  I  contrib- 
uted a  paper  in  which  I  demonstrated  the  fact,  and  to 
some  extent  the  causes,  of  the  recent  marvelous  progress  of 
surgery.  In  this,  as  in  an  earHer  publication,  I  attributed 
it  to  a  large  extent  to  vivisection.  Both  publicly  and  pri- 
vately my  statements  have  been  called  in  question. 

The  seven  years  which  have  elapsed  since  my  first  publi- 
cation on  this  subject  have  demonstrated,  far  more  than  I 
even  hoped  or  expected,  the  truth  of  what  I  then  stated, 
and  it  would  seem  right  that  some  of  these  demonstrated 
facts  should  be  laid  before  the  public.  Moreover,  the  re- 
cent revival  of  the  discussion  of  the  subject  before  the 
Church  Congress  at  Folkestone,  England,  ^  and  at  the  recent 
meeting  of  the  Humane  Society  in  Philadelphia  in  October, 
1892,  makes  it  especially  timely. 

I  shall  omit  many  topics  which  would  be  suitable,  such 
as  the  wonderful  results  of  Pasteur's  treatment  of  hydro- 
phobia, the  discoveries  of  bacteriology,  the  wholly  new 
class  of  remedies  which  medicine  owes  to  vivisection,  such 
as  the  antidotes  to  lockjaw  and  several  other  diseases,  de- 
rived from  the  blood  of  animals  inoculated  with  the  virus 
of  these  diseases  —  remedies  to  which  we  already  owe 
astonishing  cures.  In  the  present  paper  I  propose  to  limit 
myself  to  brain-surgery  alone,  and  to  give  a  glimpse  of  what 
has  been  done  up  to  the  present  time.  I  shall  show  espe- 
cially that  without  the  exact  knowledge  of  the  functions  of 
the  brain,  derived  almost  wholly  from  experimentation 
upon  animals,  it  would  be  simply  impossible  to  do  what 

1  Reprinted  by  the  kind  permission  of  Harper  &  Brothers  from 
Harper's  Magazine  for  June,  1893. 

«  Church  Times,  October  14,  1892,  p.  1021. 


46  ANIMAL  EXPERIMENTATION 

has  been  accomplished.  I  shall  not  restrict  myself  to  gen- 
eral assertions  which  may  easily  be  denied,  but  I  shall 
relate  actual  cases,  with  their  definite  results,  and  the 
authority  for  each  case. 

In  order  to  understand  modern  progress  in  cerebral  sur- 
gery it  is  necessary  first  to  understand  what  has  been 
achieved  by  experimentation  upon  the  brain.  When  I  was 
a  student  of  medicine,  thirty  years  ago,  the  brain  was  re- 
garded as  a  single  organ,  and  its  various  functions  were  not 
thought  to  have  any  especial  localized  centers  of  action.^ 
When  the  brain  acted  it  was  thought  that  the  whole  of  it 
acted,  just  as  the  liver  or  the  kidney  acts,  as  a  whole.  Now 
we  know  that  instead  of  the  brain  being  a  unit,  it  is  really 
a  very  complex  organ.  Just  as  in  the  abdomen,  besides  the 
other  organs  in  its  interior,  we  have  the  stomach,  the  liver, 
the  pancreas,  and  the  bowel,  each  of  which  has  its  part  in 
digestion,  so  correspondingly  in  the  brain,  besides  the  por- 
tions concerned  in  sight,  smell,  thought,  etc.,  we  have  four 
adjacent  portions  which  are  concerned  in  motion.  One 
produces  motion  of  the  face;  another,  motion  of  the  arm; 
a  third,  motion  of  the  leg;  and  the  fourth,  motion  of  the 
trunk. 

How,  it  may  be  asked,  have  these  facts  been  deter- 
mined? Has  it  not  been  by  observing  the  effects  of  injuries 
and  diseases  in  man?  To  a  small  extent,  yes.  But  very, 
very  rarely  does  disease  or  injury  involve  only  one  of  these 
very  limited  regions  of  the  brain;  and  the  moment  two  or 
more  of  them  are  involved  our  inferences  become  confused 
and  misleading.  As  a  matter  of  fact  which  cannot  be  gain- 
said, nine  tenths  of  our  knowledge  has  been  derived  from 
exact  experiment  upon  animals,  and  in  this  way:  A  mon- 
key is  etherized,  a  certain  area  of  its  brain  is  exposed,  and 
an  electrical  current  is  applied.  This  stimulation  of  most 

*  The  "bumps"  or  localized  centers  of  phrenology  were  always  dis- 
credited by  the  medical  profession,  and  experiments  upon  animals  and 
observation  in  man  have  entirely  overthrown  them. 


AND  MEDICAL  PROGRESS  47 

portions  of  the  brain  is  followed  by  no  motion  in  any  part 
of  the  body.  These  parts  of  the  brain,  therefore,  have  noth- 
ing to  do  with  motion,  but  are  the  centers  for  general  sen- 
sation (touch),  or  for  certain  special  senses,  as  sight,  hear- 
ing, etc.,  or  for  mental  processes.  But  in  one  definite  region 
of  the  brain,  called  the  "  motor  area,"  the  moment  the  brain 
is  stimulated  by  the  electrical  current  motion  is  produced. 
Moreover,  it  was  soon  found  that  stimulating  different 
parts  of  this  motor  area  produced  motion  in  different  parts 
of  the  body,  and  that  this  was  not  haphazard,  but  that 
stimulation  of  one  part  of  it  always  produced  motion  in  the 
arm,  and  in  another  part  always  motion  in  the  leg,  etc. 
Thus  have  been  mapped  out  the  various  portions  of  the 
motor  area,  as  will  be  presently  described  in  detail. 

It  is  evident  that  by  experiment  upon  animals  the  motor 
area  can  be  more  easily  and  more  exactly  determined  than 
can  those  regions  which  are  the  seat  of  the  faculties  of 
smell,  taste,  sight,  and  hearing,  the  presence  or  absence  of 
these  senses  in  animals  being  difficult  to  determine  with 
absolute  accuracy.  Still  more  is  this  true  of  the  parts  of  the 
brain  which  have  to  do  with  mental  processes.  Yet  dis- 
ease and  injury  in  man,  if  they  alone  could  answer  the  ques- 
tions what  part  of  the  brain  has  to  do  with  motion,  what 
part  with  sight,  what  part  with  the  intellect,  ought  to  have 
answered  them  long  ago.  No  better  evidence  could  be 
given  of  the  superiority  of  experiment  upon  animals  over 
observation  of  accident  and  disease  in  man  in  determining 
facts  of  this  character  than  this,  that  those  centers  are  best 
and  most  accurately  known  which  can  be  determined  by 
vivisection,  and  that  those  in  which  vivisection  can  aid  us 
but  little  are  still  only  vaguely  located.  Thus  the  motor 
area  is  positively  and  definitely  located;  the  area  for  sight 
approximately  well;  those  for  hearing,  smell,  and  taste 
and  general  sensation  (touch)  are  still  uncertain,  though 
guessed  at.  As  to  those  for  mental  processes,  except  per- 
haps one  which  will  be  alluded  to  later,  we  are  almost 


48  ANIMAL  EXPERIMENTATION  | 

wholly  in  the  dark.  Moreover,  disease  and  accident  have 
made  their  cruel  and  rude  experiments  ever  since  the  world 
began.  But  as  a  matter  of  fact  the  last  fifteen  years  of  ex- 
perimentation have  taught  us  more  than  the  previous  fif- 
teen hundred  years  of  careful  observation  and  of  'post- 
mortem  examination. 

Let  me  now  briefly  explain  this  "localization  of  func- 
tion" in  the  brain,  and  then  show  its  value  and  certitude 
by  cases  which  arouse  our  interest  not  only  by  their  il- 
lustrating the  practical  applications  of  science,  but  by 

the  cheering  and 
humane  results 
in  the  relief  of 
human  suffering 
and  the  saving 
of  human  life. 

Fig.  1  repre- 
sents the  motor 
area  as  ascer- 
tained by  many 
experiments  such 

Fig.  1.  Side  view  of  the  surface  of  a  monkey's  brain,  aS  I  have  de- 
showing  the  location  of  the  various  fissures  and  of  the  anriKt^rl  nT^rkn  \\m^ 
motor  centers.    (Horsley  and  SchOfer.)  bcri  ueu  upou  lue 

brains  of  mon- 
keys. On  its  surface  will  be  observed  certain  broad 
black  lines  labeled,  from  in  front  backward,  "Precentral 
sulcus.  Fissure  of  Rolando,  Intraparietal  fissure.  External 
parieto-occipital  fissure, Fissure  of  Sylvius,  Parallel  fissure," 
and  others  without  names.  In  the  middle,  running  down- 
ward and  forward  toward  the  left  hand  of  the  figure,  no- 
tice especially  the  fissure  of  Rolando.  This  and  the  fissure 
of  Sylvius  are  the  most  important  fissures  of  the  entire 
brain.  The  fissure  of  Rolando  is,  so  to  speak,  the  "axis"  of 
the  motor  area  of  the  brain.  At  its  upper  end  will  be  ob- 
served the  center  for  the  leg,  with  certain  minor  divisions 
marked  in  smaller  letters.  In  its  middle  lies  the  arm  center; 


AND  MEDICAL  PROGRESS  40 

and  it  should  be  remarked  that  the  part  where  the  word 
"retraction"  is  is  the  shoulder  center,  a  little  lower  down 
is  the  elbow  center,  and  where  "wrist  and  fingers"  occurs 
is  the  hand  center.  At  the  lower  end  of  the  fissure  of  Ro- 
lando lies  the  center  for  the  face,  and  at  other  points  will 
be  observed  the  centers  for  the  trunk  and  head.  By  the 
word  "center"  is  meant  that,  for  example,  if  you  expose  the 
part  of  the  brain  marked  "arm,"  and  apply  the  poles  of  an 
electric  battery  to  that  portion  of  the  surface  of  the  brain, 
you  will  produce  muscular  movement  in  the  arm.  If  at  the 
upper  end,  you  will  move  the  shoulder;  at  the  middle,  the 
elbow;  lower  down,  you  will  move  the  hand,  etc.  This  dia- 
gram shows  the  fissures  and  centers  as  ascertained  in  the 
brain  of  the  monkey,  but  it  must  be  remembered  that  they 
have  an  exact  parallel  in  the  human  brain.  The  same  fis- 
sure of  Rolando  exists  there,  the  same  fissure  of  Sylvius, 
the  same  intraparietal  fissure,  etc.,  as  is  seen  in  Figs.  3,  6,  8, 
and  the  same  centers  for  the  arm,  leg,  trunk,  and  head. 
When  I  state  that  these  exist  in  the  human  brain  I  am  not 
stating  what  is  theoretical,  but  that  which,  in  common  with 
scores  of  surgeons,  I  have  verified  in  many  cases  in  which  I 
have  exposed  the  human  brain,  applied  the  battery  exactly 
at  the  places  shown  in  this  diagram  of  the  monkey's  brain 
(with  such  modifications  as  would  follow  the  slightly  al- 
tered relations  of  the  same  parts  in  the  human  brain  as 
compared  with  the  monkey's),  and  have  obtained  in  man 
exactly  the  same  resulting  motions  as  have  been  thus  exper- 
imentally determined  in  the  monkey. 

Naturally  the  first  question  that  will  occur  will  be,  "This 
diagram  shows  the  fissures  and  centers  on  the  brain,  but 
how  are  you  going  to  tell  from  the  outside  of  the  head,  with- 
out opening  the  skull,  where  they  lie?  "  This  has  been  de- 
termined by  careful  study  of  the  human  brain  and  skull, 
and  their  relations  to  each  other.  I  will  give  only  one  illus- 
tration, and  that  by  far  the  most  important,  namely,  how 
we  locate  the  fissure  of  Rolando,  and  therefore  practically 


50  ANIMAL  EXPERIMENTATION 

the  whole  motor  area.  Measure  any  head  in  the  middle 
line,  from  a  point  between  the  eyebrows  to  that  bony  prom- 
inence which  any  one  of  my  readers  can  feel  at  the  back  of 
the  head  just  above  the  border  of  the  hair.  These  points 
are  called  respectively  the  "glabella"  and  the  "inion." 
Divide  this  distance  into  two  equal  parts,  and  thus  obtain 
the  mid-point  between  them.  The  fissure  of  Rolando  starts 
half  an  inch  behind  this  mid-point  between  the  glabella  and 
the  inion,  and  runs  downward  and  forward  at  an  angle  of 
67°.  There  have  been  constructed  various  simple  and  other 
complex  apparatuses  for  the  purpose  of  determining  just 
this  angle  of  67°,  but  it  was  reserved  for  Mr.  Chiene,  of 
Edinburgh,  before  the  Congress 
of  American  Physicians  and  Sur- 

i^yn^^i^^!^       geons  in  Washington,  in  Septem- 
^^^"^^^     \x  I       ber,  1891,  to  point  out  the  simplest 

possible  method  of  determining 
this  angle,  which  any  one  of  my 
readers  can  use.  If  a  square  of 
paper  be  folded  diagonally,  it  is 

FIG.  2.   Professor  Chiene's        obvioUS  that   the    right    angle    of 

method  of  finding  the  angle      90°  at  two  of  the  comcrs  is  divided 

of  the  fissure  of  Rolando.  .    .      .  i     i  .  i  i^ 

into  two  halves,  or  two  angles  of 
45°  each.  If  the  paper  be  then  again  folded  so  as  to  di- 
vide one  of  these  angles  of  45°  into  two  angles  of  22.5° 
each,  it  is  evident  that  one  angle  of  45°  and  another  of  22.5° 
make  an  angle  of  67.5°,  which  varies  only  half  a  degree 
from  that  of  the  fissure  of  Rolando.  (Fig.  2.)  If  the  middle 
line  of  the  head  be  marked  with  an  aniline  pencil  on  the 
shaven  scalp,  if  its  mid-point  be  then  fixed,  and  if  the  strip 
of  paper  just  described  be  so  placed  that  its  edge  indicating 
the  angle  of  67.5°  runs  downward  and  forward  from  a  point 
half  an  inch  back  of  the  mid-point,  the  edge  will  correspond 
to  the  line  of  the  fissure  of  Rolando,  and  can  be  marked  by 
the  aniline  pencil  on  the  scalp.  If  this  line  be  measured  for 
a  distance  of  Sf  inches  from  the  middle  line  of  the  head,  the 
length  of  the  fissure  of  Rolando  is  also  shown. 


AND  MEDICAL  PROGRESS  51 

It  is  not  necessary  for  me  to  go  further  into  details.  I 
propose  now,  after  having  thus  explained  the  "localization 
of  function"  in  the  brain,  and  the  means  of  locating  the 
motor  area  from  the  exterior,  to  show  not  only  that,  as  a 
matter  of  fact,  it  has  been  verified  in  actual  surgical  experi- 
ence, but  also  that  it  is  so  accurate  that  from  the  exterior  of 
the  head,  without  any  scar  or  other  evidence  of  injury  (or 
even  in  the  presence  of  an  otherwise  misleading  scar),  with- 
out any  fracture  of  the  skull,  without  any  lump,  promi- 
nence, or  other  means  to  guide  us,  cerebral  localization  is  a 
reality,  and  as  reliable  as  the  needle  of  the  compass  itself  to 
guide  us  exactly  to  the  correct  spot,  so  that  we  can  open  the 
head  and  expose  the  brain  with  an  accuracy  which  is  truly 
marvelous.  If  the  last  fifteen  years  of  experimentation 
have  done  so  much,  what  may  we  not  expect  in  the  next 
fifteen?  Does  not  humanity  as  well  as  science  protest 
against  any  hindrance  to  the  further  prosecution  of  work 
which  has  accomplished  such  results?  Is  this  the  work  of 
"inhuman  devils,"  as  Canon  Wilberforce  has  been  pleased 
to  term  those  engaged  in  it,  or  is  it  the  work  of  humane  men 
of  science  anxious  to  mitigate  human  suffering  and  prolong 
human  life? 

Now  let  us  see  what  results  practical  surgery  has  given 
us  by  the  application  of  the  doctrines  of  cerebral  localiza- 
tion of  function  to  special  cases,  otherwise  beyond  our 
power  exactly  to  diagnosticate  and  to  relieve.  In  each  case 
I  give  the  published  authority,  or,  if  the  case  has  not  yet 
been  published,  the  records  are  accessible  in  the  hospitals 
named.  The  cases  are  not  of  the  time  of  John  Hunter  or  of 
Sir  Charles  Bell,  but  of  the  last  few  years,  and  can  be  inves- 
tigated and  verified  now. 

The  first  case  shows  that  it  is  possible  not  only  to  diag- 
nosticate in  general  the  fact  that  an  abscess  exists  in  the 
brain,  but  to  locate  it  exactly,  and  to  open  it  with  the  same 
precision  as  in  opening  an  abscess  on  the  hand.  What  is 
more  to  the  point,  in  about  one  half  of  such  cases  we  can 


52  ANIMAL  EXPERIMENTATION 

now  cure  the  patients  who,  before  vivisection  had  taught 
us  modern  cerebral  localization,  would  all  have  gone  to 
their  graves. 

Case  I.  Abscess  in  the  brain.  In  the  "British  Medical 
Journal"  of  April  21,  1888,  Mr.  Darner  Harrisson  records 
the  following  case.  A  boy  aged  fifteen  had  received  a  blow 
on  the  right  side  of  his  head  from  a  pair  of  tongs  eight  days 
before  his  admission  to  the  hospital.  Three  days  after  the 
accident  a  convulsion  suddenly  set  in,  involving  the  right 
side  of  the  body,  beginning  in  the  arm  and  spreading  to  the 
leg  and  face,  and  followed  rapidly  in  four  days  by  eight 
other  convulsions  and  paralysis  of  the  entire  right  side  of 
the  body.  Most  of  my  readers  would  unhesitatingly  attrib- 
ute the  convulsions  and  the  paralysis  to  this  blow  from  the 
tongs.  But  it  must  be  remembered  that  the  right  side  of 
the  brain  supplies  the  left  side  of  the  body,  and  vice  versa. 
Hence  Mr.  Harrisson  suspected  that  the  paralysis  of  the 
right  side  of  the  body  indicated  trouble  in  the  left  half  of 
the  brain.  Examining  his  head,  he  found  on  the  left  side  a 
small  scar  at  the  junction  of  the  arm  and  leg  centers.  In- 
quiry elicited  the  fact  that,  ten  years  before,  he  had  received 
a  severe  blow  there,  which,  however,  had  not  been  followed 
by  any  serious  symptoms.  Could  this  old  injury,  after  so 
long  a  time  as  ten  years,  possibly  be  the  cause  of  his  present 
serious  trouble?  Further  inquiry  brought  out  the  fact  that 
for  about  a  year  before  his  admission  the  boy  had  had  re- 
peated twitching  of  his  right  arm.  So  convinced  was  Mr. 
Harrisson  that  modern  cerebral  localization  was  right  that 
he  opened  the  boy's  skull,  not  where  most  people  would 
suppose  would  be  natural,  namely,  on  the  right  side  of  the 
head,  where  he  had  received  the  blow  from  the  pair  of 
tongs  eight  days  before,  but  on  the  left  side,  at  the  site  of 
the  blow  ten  years  before,  and  at  a  definite  point,  namely, 
over  the  fissure  of  Rolando,  at  the  place  corresponding  to 
the  motor  center  for  the  arm  as  established  by  experiments 
on  animals.  Although  the  first  injury  was  received  so  long 


I 


AND  MEDICAL  PROGRESS  53 

before,  yet  the  paralysis  showed  that  it  was  the  left  side  of 
the  brain  that  was  involved,  and  the  twitching  of  the  arm 
showed  that  this  was  the  particular  part  of  the  left  side  of 
the  brain  where  the  injury  probably  existed.  Mr.  Harris- 
son  punctured  what  seemed  on  the  surface  to  be  a  normal 
brain,  and  opened  an  abscess,  and  this  boy,  otherwise  abso- 
lutely doomed  to  death,  made  an  uninterrupted  recovery. 
This  is  only  one  instance  out  of  probably  more  than  one 
hundred  and  fifty  cases  of  abscess  in  the  brain  which  have 
been  reported  within  the  last  seven  or  eight  years  which 
have  been  diagnosticated  with  the  same  accuracy  and  by 
the  same  means. 

Case  II.  In  the  "British  Medical  Journal"  for  Au- 
gust 11,  1888,  Dr.  (later  Sir  William)  Macewen,  of  Glas- 
gow, relates  the  case  of  a 
patient  who,  among  other 
symptoms  of  abscess  of  the 
brain,  had  partial  paralysis 
of  the  right  side  of  the  face 
and  right  arm,  and  paralysis 
of   the  nerve  supplying  the 

Ipft  pvpbflll  For  reasons  ^^^- ^'  Case  II.  Side  view  of 
leit      eyeoau.       ror      reasons       the  human  brain.   The  shaded  area 

stated  in  the    paper   he    con-       sliows  the  location  of  the  abscess 

producing  pressure  on  the  lower 
eluded,  with   great   acuteness       part  of  the  motor  area.  (See  Fig.  1.) 

of  reasoning,  that  the  ab- 
scess could  not  be  in  the  motor  area  for  the  face  and  arm 
on  the  left  side  of  the  brain,  but  in  the  projecting  part  of 
the  brain  just  below  these  centers,  but  producing  pressure 
upon  them.  (Fig.  3.)  He  confidently  operated  at  this  pre- 
cise spot,  and  opened  an  abscess  inside  of  the  brain  in  the 
exact  position  described,  and  gave  exit  to  six  tahlespoonfuls 
of  pus,  when  the  symptoms  vanished,  and  in  three  weeks 
the  patient  was  well! 

Brain  tumors.  Nothing  could  be  easier  than  to  locate  a 
tumor  of  the  brain  which  showed  itself  externally.  In  a 
case  in  which  the  tumor  is  as  large  as  that  shown  in  Fig.  4 


54  ANIMAL  EXPERIMENTATION 

(which  IS  the  natural  size  of  a  tumor  removed  from  a  man 
who  is  still  living,  five  years  after  the  operation)  ^  it  might 
be  thought  easy  to  locate  it,  though,  as  a  matter  of  fact,  it 
is  very  difficult,  owing  to  the  large  area  of  brain  involved. 
But  when  I  say  that  the  existence  of  a  tumor  about  the 
size  of  the  end  of  the  forefinger  can  be  diagnosticated,  and 


Fig.  4.    Natural  size  of  a  tumor  removed  from  the  brain.    The  patient  is 
living  after  twenty-seven  years.  (1914.) 

that  before  touching  the  head  it  should  be  said  (and  I  was 
present  when  the  statement  was  made),  that  it  was  a  small 
tumor,  that  it  did  not  lie  on  the  surface  of  the  brain,  but  a 
little  underneath  it,  and  that  it  lay  partly  under  the  center 
for  the  face  and  partly  under  that  for  the  arm  in  the  left 
side  of  the  brain,  and  that  the  man  was  operated  on,  and 
the  tumor  found  exactly  where  it  was  believed  to  be,  with 
perfect  recovery  of  the  patient,  it  is  something  which  ten 
years  ago  would  have  been  deemed  the  art  of  a  magician 
rather  than  the  cold  precision  of  science. 

Case  III.  In  the  "American  Journal  of  the  Medical 
Sciences"  for  July,  1888,  this  case  is  detailed  by  Drs.  Se- 
guin  and  Weir,  as  follows.  A  gentleman  thirty-nine  years 
of  age  had  been  perfectly  healthy  until  August,  1882,  when 

*  He  is  still  alive  in  1914,  twenty-seven  years  after  the  operation.    ; 


AND  MEDICAL  PROGRESS 


55 


he  had  malarial  fever,  accompanied  with  a  good  deal  of 
pain.  One  day,  as  he  rose  to  go  to  the  window,  his  wife  no- 
ticed a  spasm  of  the  right  cheek  and  neck,  which  did  not 
involve  the  arm,  nor  was  consciousness  lost.  In  1886,  two 
or  three  similar  attacks  having  occurred  in  the  interval,  he 
fell,  unconscious,  and  bit  his  tongue.  These  attacks  were 
all  accompanied  with  twitching  of  the  right  arm  and  hand 
and  right  side  of  the  face.  His  memory  became  impaired 
and  his  speech  thick.  No  injury  had  ever  been  received  on 
his  head,  nor  was  anything  abnormal  observed  even  when 
his  head  was  shaved.  Gradually  his  right  hand  and  arm 
became  weak,  and,  as  a  result,  his  handwriting  became  bad. 
This  weakness  of  the  right  arm  slowly  increased,  and  along 
with  it  a  weakness  of  the  right  leg,  and,  as  a  consequence  of 
the  increasing  paralysis  of  his  face,  drooling  at  the  right 
side  of  the  mouth  set  in. 

Dr.  Weir  examined  him  at  Dr.  Seguin*s  request,  and 
both  of  them  reached  a  diagnosis,  chiefly  based  upon  the 
facts  already  given,  that 
the  man  had  a  small  tu- 
mor situated  as  above 
described,  and  on  No- 
vember 17, 1887,  the  skull 
was  opened  at  the  junc- 
tion of  the  arm  and  face 
centers.  This  operation  I 
had  the  pleasure  of  wit- 
nessing personally.  Noth- 
ing abnormal  was  seen  on 
the  surface  of  the  brain. 
Yet  so  confident  was  Dr. 
Weir  of  the  correctness 
of  the  diagnosis  that  he 
boldly  cut  into  the  brain 
substance,  and  from  its  interior  removed  a  tumor  of  the 
size  indicated  by  means  of  a  small  surgical  spoon.    The 


Fig.  5.  Case  HE.  A  cross-section  of  the 
brain  (only  a  part  of  the  left  side  is 
shown.)  The  round  shaded  spot  rep- 
resents the  brain  tumor.  (Weir  and 
Seguin.) 


56  ANIMAL  EXPERIMENTATION 

man  made  a  perfect  recovery.  When  examined  microscop- 
ically, the  tumor  was  found  to  be  of  a  malignant  charac- 
ter. It  returned  in  about  four  years,  and  finally  destroyed 
his  life.  Fig.  5  shows  the  tumor  represented  as  a  little  ball 
in  the  substance  of  the  brain. 

In  one  sense,  as  a  surgical  feat,  the  removal  of  a  tumor 
as  large  as  that  shown  in  Fig.  4  is  a  much  more  difficult  and 
extraordinary  operation  (and  one  nearly  twice  as  large, 
weighing  over  half  a  pound,  has  lately  been  successfully 
removed  by  Bramann!);  but  as  a  matter  of  diagnosis  and 
of  surgical  skill,  locating  and  removing  so  small  a  tumor 
from  the  brain  so  successfully,  and  without  the  slightest 
indication  on  the  exterior  to  guide  one,  is  a  much  more  bril- 
liant and  remarkable  operation. 

In  an  address  which  I  published  in  1885^  I  alluded  to  the 
first  and  then  the  only  case  known  of  removal  of  a  brain 
tumor,  and  I  said:  — 

By  these  experiments  and  operations  a  wide  door  is  opened  to 
surgery  in  the  treatment  of  diseases  within  the  skull,  diseases 
heretofore  so  obscure  and  uncertain  that  we  have  hardly  dared 
to  attack  them.  The  question  is  not  whether  death  or  recovery 
followed  in  this  particular  case.  The  great,  the  startling,  the 
encouraging  fact  is  that  with  this  experience  we  can  now,  with 
well-nigh  absolute  certainty,  diagnosticate  the  existence  of,  and 
with  the  greatest  accuracy  locate,  such  diseases,  and  therefor© 
reach  them  by  operation,  and  treat  them  successfully. 

That  my  prophecy  has  been  verified,  let  me  quote  the 
statistics  gathered  by  Dr.  Knapp,  of  Boston,  in  1891.  He 
collected  forty-six  cases  of  operations  for  tumors  of  the 
brain,  operated  on  in  the  last  six  years,  of  which  thirty  re- 
covered (!),  fifteen  died,  and  the  result  was  unknown  in 
one.  It  must  be  remembered  that  these  thirty  which  re- 
covered would  every  one  of  them  have  died  had  not  vivi- 
section given  us  the  means  of  accurately  locating  the  dis- 
ease. That  we  have  not  yet  reached  the  accuracy  which  is 
*  "  Our  Recent  Debts  to  Vivisection,"  ante,  p.  13. 


AND  MEDICAL  PROGRESS  57 

to  be  desired  is  shown  by  the  fact  that  in  fifteen  other  cases 
no  tumor  was  found  at  the  point  of  operation,  and  of  these 
thirteen  died.  Most  of  these  tumors  lay  not  in  the  motor 
region  of  the  brain,  but  in  other  parts  of  it,  in  which  our 
means  of  diagnosis  are  as  yet  very  imperfect  for  the  very 
reason  that  vivisection  has  thrown  but  little  light  on  the 
function  of  these  regions.  There  were  also  four  cases  of 
tumors  which  were  found,  but  were  so  large  as  to  be  irre- 
movable, and  of  these  three  died.  To  these  statistics  I  can 
add  three  other  cases.  In  one  of  these  the  tumor  was  not 
rightly  located  (it  was  not  in  the  motor  region),  and  there- 
fore was  not  found  at  the  operation,  and  the  patient  died. 
In  the  other  two  cases  the  tumor  was  found,  but  was  irre- 
movable. One  patient  died,  and  the  other  recovered  from 
the  operation,  but  died  from  the  disease  four  months  after- 
wards. He  had,  however,  been  relieved  from  the  atrocious 
headaches  which  rendered  life  a  burden,  and  his  delusional 
insanity  had  almost  wholly  disappeared  —  results  which 
fully  justified  the  operation  by  the  comfort  of  his  few  re- 
maining days.^ 

Case  IV.  Hemorrhage  inside  the  skull.  Let  me  next  give 
a  case  of  a  different  character,  but  equally  accurate  and 
astonishing.  An  artery  about  as  large  as  the  lead  in  an  or- 
dinary lead-pencil  runs  in  the  membranes  of  the  brain  on 
the  inside  of  the  skull,  in  the  region  called  "the  temple," 
and  grooves  the  bones  quite  deeply.  In  some  cases  in  which 
a  heavy  blow  is  received  on  the  surface  of  the  skull,  without 
fracture,  or  it  may  be  even  without  leaving  any  mark  what- 
ever on  the  skull,  this  artery  is  ruptured,  and  a  large  clot  is 
poured  out  on  the  surface  of  the  brain.  Formerly  it  was 
not  only  almost  impossible  to  make  a  diagnosis  of  such  an 
injury,  but,  even  if  the  rupture  of  the  artery  was  suspected, 

*  Another  remarkable  case,  in  which  a  growth  of  the  under  surface  of 
the  bone  pressing  on  the  arm  center  was  exactly  located  and  successfully 
removed,  is  related  by  Dr.  A.  B.  Shaw,  of  St.  Louis.  (American  Journal 
of  the  Medical  Sciences,  December,  1892,  p.  691.) 


53  ANIMAL  EXPERIMENTATION 

before  antiseptic  surgery  (itself  the  child  of  vivisection) 
arose,  such  patients  were  only  treated  with  a  little  opium, 
rest,  and  regulated  diet.  Most  of  them  died,  but  occasion- 
ally one  got  well.  Of  147  cases  collected  by  Wiesmann 
which  were  not  operated  on,  131,  or  over  89  per  cent,  died. 
The  symptoms  of  such  an  injury  are  fairly  clear,  but,  until 
the  doctrines  of  cerebral  localization  were  accepted,  were 
often  misleading.  The  patient  is  stunned  by  the  blow,  but 
usually  recovers  consciousness,  only  to  relapse  again  into 
unconsciousness  when  the  amount  of  blood  poured  out  is 
sufficient  to  compress  the  brain,  this  compression  of  the 
brain  producing  also  paralysis.  Generally  the  artery  on  the 
same  side  of  the  head  as  the  blow  is  ruptured,  and  the  par- 
alysis will  be  on  the  opposite  side  of  the  body.  But  some- 
times, instead  of  the  artery  being  ruptured  on  the  same 
side  as  the  blow,  it  will  be  ruptured  on  the  opposite  side; 
or,  again,  if  the  blow  be  in  the  middle  line,  as  in  a  case  re- 
cently under  my  care,  it  may  be  difficult  to  tell  which  side 
has  been  involved.  Moreover,  as  the  artery  splits  into  two 
branches,  one  of  which  runs  in  the  direction  of  the  motor 
region  and  the  other  back  of  it,  it  may  be  difficult  to  know 
where  to  open  the  skull  in  order  to  reach  it.  Now  it  is  very 
evident  that  if  we  make  an  incision  into  the  forearm  to 
reach  an  abscess  or  a  tumor,  and  it  is  found  that  the  trouble 
lies  one  or  two  inches  further  up  or  down,  the  incision  can 
be  easily  prolonged  in  the  right  direction,  and  will  heal 
readily.  But  in  the  skull  our  diagnosis  must  be  correctly 
located  within  a  very  small  limit  of  error,  for  it  is  evident 
that  we  cannot  enlarge  the  opening  in  the  bone  at  will  to 
almost  any  extent,  as  we  can  in  the  flesh.  Wiesmann  has 
also  collected  110  cases  which  were  thus  operated  on,  of 
whom  36  died,  or  only  33  per  cent!  *  What  a  contrast  to  the 
89  per  cent  of  deaths  when  no  operation  was  performed! 
In  the  majority  of  these  36  who  died  the  clot  was  not  found, 

"  *  See  "  Midshipman  Aiken  and  Vivisection,"  post,  p.  146,  whose  life 
was  saved  by  operation. 


I 


AND  MEDICAL  PROGRESS  69 

and  was  therefore  not  removed,  because  in  the  earlier  days 
we  lacked  the  boldness  and  therefore  the  exactness  of 
modern  times. 

Case  V.  Let  me  now  give  the  case  furnished  me  by  Dr. 
Dench,  by  permission  of  Dr.  Bull,  of  New  York.*  A  young 
man  had  been  shot  in  the  head,  the  ball  entering  above  the 
ear,  two  and  a  half  inches  to  the  left  of  the  middle  line  of 
the  head.  When  first  seen  his  right  arm  was  paralyzed,  and 
shortly  afterward  the  paralysis  had  extended  to  the  right 
leg  and  right  face.  A  diagnosis  was  made  of  hemorrhage 
from  one  of  the  arteries  of  the  brain,  by  reason  of  the  fact 
that  the  paralysis  had  extended  so  rapidly  from  the  arm  cen- 
ter to  the  leg  and  face  centers,  for  no  other  cause  excepting 
hemorrhage  could  be  so  rapidly  progressive.  The  wound  was 
exposed,  and  a  considerable  clot  gushed  out,  when  motion 
immediately  returned  in  the  leg.  The  bone  was  then  tre- 
phined, not  at  the  bullet  opening,  but  a  quarter  of  an  inch 
below  and  in  front  of  the  wound,  when  this  bleeding  me- 
ningeal artery  was  exposed  and  tied.  It  was  found  that  a 
large  branch  of  an  artery  in  the  brain  itself  had  also  been 
severed.  This  was  tied,  and  in  two  months  the  man  was 
well,  no  fever  following,  and  no  "matter"  having  formed. 
He  could  speak  perfectly  well,  and  could  use  his  arm,  but 
not  his  hand.  The  ball  was  never  found. 

Case  VI.  It  may  be  objected  that  here  there  was  a 
wound  to  point  out  exactly  the  situation  of  the  injury.  Let 
me  therefore  give  a  somewhat  similar  case  in  which  no 
such  guide  existed:  M.  Michaux^  reports  a  case  of  trephin- 
ing, followed  by  cure,  for  a  case  of  meningeal  hemorrhage, 
probably  of  spontaneous  origin.  A  man  was  brought  to  the 
hospital  in  a  state  of  complete  apoplexy,  with  paralysis  of 
the  left  face  and  right  arm.  There  was  no  sign  of  fracture 
or  other  injury.    During  the  next  few  days  the  paralysis 

1  Buck's  Reference  Handbook  of  the  Medical  Sciences^  vol.  viii,  p.  227. 
*  Medical  News,  May  2,  1891,  p.  504,  from  Revue  de  Chirurgie,  1891, 
vol.  XI,  p.  376. 


60  ANIMAL  EXPERIMENTATION 

extended  to  the  right  leg.  Epileptic  convulsions  set  in,  at 
first  limited  to  the  paralyzed  regions,  then  becoming  gen- 
eral. Occurring  at  intervals  in  the  beginning,  they  became 
continuous  at  the  end  of  three  or  four  days.  The  patient 
was  addicted  to  absinthe,  and  his  head  had  troubled  him 
for  several  months.  The  trephine  was  applied  over  the  fis- 
sure of  Rolando  on  the  left  side,  over  the  "motor  area"  for 
the  arm  and  leg,  and  an  opening  six  centimeters  long  was 
made,  through  which  the  membranes  of  the  brain  were  in- 
cised. This  was  followed  immediately  by  the  escape  of 
four  tablespoonfuls  of  large  blackish  clots  After  the  oper- 
ation the  patient  improved  rapidly,  and  in  a  month  most 
of  the  symptoms  had  disappeared. 

Drs.  Bremer  and  Carson,  of  St.  Louis,^  and  Drs.  Rom- 
ans and  Walton,  of  Boston,^  have  published  cases  in  which, 
also  without  external  signs,  such  clots  have  been  accur- 
ately located  and  removed  with  success.  In  the  latter  case 
there  was  evidence  of  an  injury,  but  the  clot  was  on  the 
opposite  side  of  the  head. 

Mental  disorders.  I  shall  now  add  a  case  involving  the 
centers  for  mental  processes,  in  the  establishment  of  which 
vivisection  has  done  but  little,  for  reasons  already  ex- 
plained, but  the  case  is  one  of  great  interest  and  value. 

If  the  reader  will  look  at  Fig.  1,  find  the  fissure  of  Sylvius 
and  follow  it  to  its  upper  end,  he  will  see  that  this  end  ter- 
minates in  a  A-shaped  convolution  between  the  intraparie- 
tal  and  the  external  parieto-occipital  fissures.  In  this  por- 
tion of  the  brain  have  been  located  certain  mental  processes, 
including  the  ability  to  recognize  objects  and  their  uses. 
The  location  of  this  convolution  of  the  brain  can  be  made 
with  almost  the  same  accuracy  as  that  of  the  fissure  of 
Rolando. 

Case  VII.   The  following  case  of  Macewen  of  Glasgow^ 

1  American  Journal  of  the  Medical  Sciences,  February,  1892,  p.  134. 

2  Boston  Medical  and  Surgical  Journal,  February  li,  1891. 

3  British  Medical  Journal,  August  11,  1888,  p.  306. 


AND  MEDICAL  PROGRESS  61 

will  illustrate  the  accuracy  of  this  localization.  A  year  be- 
fore Macewen  saw  him  the  patient  had  received  an  injury 
which  had  resulted  in  melancholia.  Though  formerly  a 
happy  husband  and  father,  he  now  repeatedly  contem- 
plated the  murder  of  his  wife  and  children.  There  were  no 
phenomena  connected  with  motion  in  any  part  of  the  body 
by  which  the  injury  could  be  located;  but  it  was  discovered 
by  that  careful,  close  investigation  for  which  this  surgeon 
is  so  well  known  that,  immediately  after  the  accident,  for 
two  weeks  he  had  suffered  from  what  is  called  "psychical 
blindness,"  or  "mind  blindness";  that  is  to  say,  his  physi- 
cal sight  was  not  at  all  affected,  but  his  mind  was  not  able 
to  interpret  what  he  saw.  I  presume  he  was  a  stanch 
Scotch  Presbyterian.  He  knew  that,  as  was  customary,  his 
New  Testament  was  lying  by  his  side,  but  when  he  looked 
at  it  he  was  utterly  unable  to  recognize  it.  While,  however, 
his  mental  sight  was  thus  affected,  his  sense  of  touch  was 
perfect,  and  when  he  passed  his  hand  over  the  smooth 
leather  cover  of  his  well-known  book  and  felt  the  deep- 
indented  letters  on  the  back  he  recognized  it  as  his  familiar 
friend;  but  when  he  opened 
it,  the  printed  words  were  un- 
known symbols  to  him.  This 
gave  to  Macewen  the  key  to 
the  injury.  He  located  on  the 
outside  of  the  skull  this  A- 
shaped   convolution    (Fig.    6,        fig.g.  ca^Tvii.  side  view  of 

shaded    area) ,    known    as    the       ^^^  human  brain.      The  shaded 

t(  I  ,,         J     «         J         area     shows    where     the    bone 

angular   gyrus,      and    found,       pressed  on  the  A-shaped  angular 

on  removing  a  button  of  bone,  ^^'''''  (m^^^^^"-) 
that  a  portion  of  the  inner  layer  of  the  bone  had  become 
detached  and  was  pressing  on  the  brain,  one  corner  of  it 
being  imbedded  in  the  brain  substance.  After  removing 
the  splinter,  the  button  of  bone  was  replaced  in  its  proper 
position.  The  man  got  well,  and,  although  still  excitable, 
lost  entirely  his  homicidal  tendencies  and  returned  to  work. 


62  ANIMAL  EXPERIMENTATION 

Epilepsy.  If  I  were  to  gather  together  the  operations 
which  have  been  done  for  epilepsy  since  we  have  been  able 
to  locate  the  centers,  especially  for  motion,  I  should  per- 
haps have  to  record  one  hundred  and  fifty  or  more.  The 
great  majority  of  these  patients  have  recovered  from  the 
operation,  or,  in  surgical  parlance,  have  made  an  "opera- 
tive recovery,"  but  in  a  very  large  proportion  the  disease 
has  returned,  generally,  however,  with  a  lessened  intensity. 
In  a  small  proportion  recovery  has  taken  place  from  the 
disease  itself.  But  it  is  evident  that  as  cerebral  surgery 
covers  practically  only  the  last  eight  or  ten  years,  it  is 
much  too  early  to  formulate  definitely  a  statement  of  what 
the  results  may  be  when  a  longer  time  has  elapsed. 

Case  VIII.  In  the  "American  Journal  of  the  Medical 
Sciences"  for  December,  1891,  Dr.  Charles  K.  Mills,  of 
Philadelphia,  has  reported  the  case  of  a  young  lady  twenty- 
seven  years  of  age,  who  suffered  for  some  time  from  numb- 
ness and  a  sense  of  weight  in  the  left  arm,  hand,  and  foot. 
After  about  five  years  these  attacks  developed  into  distinct 
epileptic  fits,  and  had  become  extremely  frequent  at  the 
time  when  Dr.  Mills  first  saw  her,  in  November,  1890.  The 
attacks  occurred  both  in  the  daytime  and  at  night,  and 
were  as  frequent  as  ten  to  fifteen  in  the  twenty-four  hours. 
Dr.  Mills  himself  often  saw  them.  The  left  arm  was  first 
raised,  the  motion  beginning  in  the  shoulder,  and  includ- 
ing also  the  elbow.  The  attack  quickly  extended  over  the 
entire  body.  On  the  outside  of  the  head,  after  it  had  been 
shaved,  absolutely  nothing  was  found  which  could  be  a 
guide  to  the  site  of  the  trouble.  The  diagnosis  was  some 
source  of  irritation,  the  character  of  which  was  unknown, 
but  which  was  located  on  or  in  the  center  for  the  left  shoul- 
der. Accordingly  the  fissure  of  Rolando  was  mapped  out 
on  the  shaven  head,  and  a  button  of  bone  an  inch  and  a  half 
in  diameter  was  removed,  the  center  of  which  was  an  inch 
and  three-quarters  to  the  right  of  the  middle  line.  Fig.  7 
shows  the  button  of  bone,  the  inner  surface  being  upper- 


AND  MEDICAL  PROGRESS 


63 


Fig.  7.  The  button  of  bone  re- 
moved in  Case  VIII.  The  pits  in 
the  bone  were  produced  by  the 
tumor.  They  were  ahnost  pre- 
cisely in  the  center  of  the  button, 
and  thus  show  how  exactly  the 
tumor  was  located.    (Mills.) 


most.  The  bone  was  very  thick,  from  five  to  seven  six- 
teenths of  an  inch,  and  was  also  very  dense.  As  soon  as  the 
bone  was  removed,  a  small 
tumor  resembling  in  shape  a 
minute  bunch  of  grapes  was 
found,  the  apex  of  the  tumor 
being  within  one  sixteenth  of  an 
inch  of  the  point  where  it  was 
believed  to  exist.  By  its  pres- 
sure it  had  produced  several 
pits  on  the  inner  surface  of  the 
bone,  and  these  holes,  as  well 
as  the  groove  for  a  large  blood- 
vessel which  supplied  the  tu- 
mor with  blood,  are  well  shown 
in  the  middle  of  the  button. 
The  tumor,  with  the  membrane  of  the  brain  to  which 
it  was  attached,   was  removed,  and  the   battery   was 

then  applied  to 
the  brain  imme- 
diately under- 
neath it.  ^  Fig.  8 
shows  the  fissure 
of  Rolando  as 
a  line  running 
downward  and 
forward  across 
the  circle.  The 
circle  represents 
the  button  of 
bone  removed, 
and  the  numbers 
1  to  4  represent 
the  points  at 
which  the  poles  of  the  battery  were  applied  to  the  brain. 
On  stimulating  the  brain  at  the  point  marked  1,  and 


riQ.  8.  The  brain  in  Case  VIIL  The  circle  shows 
where  the  button  of  bone  was  removed,  and  the  growth 
found  almost  exactly  at  the  center  of  the  button. 
(Mills.) 


64  ANIMAL  EXPERIMENTATION 

again  at  point  2,  movements  of  the  arm  at  the  shoulder 
and  elbow  were  reproduced;  precisely  the  movements  of 
her  attacks.  This  point  was  the  portion  of  the  brain 
pressed  upon  by  the  tumor.  Along  with  the  movements  of 
the  shoulder  at  point  1  the  elbow  was  involved,  and  at 
point  2  it  was  found  that  the  hip  and  knee  were  both  flexed, 
and  the  entire  leg  carried  away  from  its  fellow,  the  toes  and 
foot  being  extended.  It  was  very  evident,  then,  that  point 
1  corresponded  to  the  shoulder  and  elbow  centers,  and 
point  2  corresponded  to  the  upper  edge  of  the  shoulder 
center  and  also  to  the  edge  of  the  leg  center.  Excitation 
at  point  3  was  followed  by  more  decided  movements  of  the 
lower  arm,  and  at  point  4  the  leg  alone  moved,  the  shoulder 
not  being  involved. 

Could  any  better  illustration  be  found  of  the  accuracy  of 
localization?  The  leg  center  here,  when  compared  with  the 
leg  center  in  Fig.  1  of  the  monkey's  brain,  is  found  exactly 
where  it  ought  to  be,  the  arm  center  directly  below  it,  with 
the  shoulder,  elbow,  wrist,  and  hand  movements  precisely 
in  the  same  relative  positions  as  in  the  monkey's  brain. 
Unfortunately  the  lady  has  not  been  cured.  But  the  fits 
have  been  greatly  moderated,  so  that  when  the  case  was 
reported,  nearly  a  year  after  the  operation,  she  had  usually 
only  about  three  attacks  in  the  twenty-four  hours  instead 
of  ten  or  fifteen,  and  the  attacks  had  never  attained  the 
same  severity  as  before  the  operation.  Moreover,  after  the 
operation,  in  about  half  the  attacks  she  did  not  lose  con- 
sciousness, and  so  was  far  less  exposed  to  the  danger  of  fall- 
ing the  downstairs,  into  fire,  and  other  similar  perils  to 
which  epilepsy  with  unconsciousness  exposes  a  patient. 

Case  IX.  Another  case,  which  is  fortunately  more  fa- 
vorable in  its  result,  is  published  in  the  "Medical  News"  of 
April  12, 1890.  A  little  boy,  six  and  a  half  years  old,  at  the 
age  of  fourteen  months  fell  about  ten  or  twelve  feet  from  a 
haymow  upon  a  plank  flooring.  He  was  unconscious  for 
some  time.  No  decisive  evidence  of  injury  could  be  found 


AND  MEDICAL  PROGRESS  65 

either  on  his  head  or  other  parts  of  his  body,  but  from  his 
prolonged  unconsciousness  it  was  presumed  that  he  had 
struck  his  head.  Soon  after  this  accident  his  disposition 
changed  materially  for  the  worse.  He  became  irritable,  ob- 
stinate, and  ill-tempered,  and  very  frequently  kicked,  bit, 
and  scratched,  and  offered  other  violence  to  his  playmates. 
His  room  had  to  be  padded,  his  clothes  had  to  be  sewed  on 
him  every  morning,  and  he  would  kill  any  small  animals, 
such  as  cats  or  chickens,  that  came  in  his  way.  When  two 
and  a  half  years  old  his  first  epileptic  fit  occurred.  He  had 
from  three  to  six  attacks  a  day,  with  some  intervals  of  com- 
parative freedom.  His  father,  an  intelligent  clergyman, 
estimated  that  in  the  four  years  since  his  epilepsy  began  he 
had  had  over  five  thousand  fits!  Of  these  about  eighty  per 
cent  began  in  the  right  hand.  The  attacks  were  observed 
with  great  care  in  the  Jefferson  Medical  College  Hospital 
by  a  special  nurse,  and  the  statement  of  his  father  that  they 
usually  began  in  the  right  hand  was  verified.  When  the 
attacks  began  the  child  had  a  vocabulary  of  about  forty 
words,  but  gradually  these  were  reduced,  word  by  word, 
until  his  speech  consisted  only  of  three  words  and  a  little 
jargon,  the  words  being  "papa,"  "mamma,"  and,  charac- 
teristically "no,"  rather  than  "yes."  Examination  of  the 
head  revealed  nothing  that  could  locate  any  injury;  but  as 
the  attacks  began  so  constantly  in  the  right  hand,  it  was 
resolved  to  remove  the  center  for  this  part  of  the  body,  in 
the  hope  that  if  the  fits  were  prevented  at  their  initial  spot 
they  would  not  begin  elsewhere.  The  fissure  of  Rolando 
was  first  located,  then  the  position  of  the  hand  center  was 
marked,  and  a  disk  of  bone  an  inch  and  a  half  in  diameter 
was  removed.  The  membranes  of  the  brain  were  then 
opened,  and  the  brain  itself  exposed.  Nothing  abnormal 
was  perceptible  either  by  eye  or  by  touch.  The  battery  was 
applied  to  the  portion  of  the  brain  exposed,  producing 
movements  of  the  hand,  showing  that  the  center  had  been 
correctly  mapped  from  the  outside  of  the  skull.  Excitation 


66  ANIMAL  EXPERIMENTATION 

of  the  brain  further  upward  produced  elbow  movements 
(elbow  center) .  These  centers  were  therefore  exactly  where 
they  ought  to  lie,  as  shown  in  the  monkey's  brain  (Fig.  1). 
The  portion  of  the  brain  that  moved  the  hand  was  then 
removed,  and  when  the  battery  was  applied  to  the  parts 
around  it,  it  was  found  that  all  the  center  for  the  hand  and 
wrist  had  been  removed. 

The  boy  made  a  speedy  recovery  from  the  operation. 
Three  years  have  now  elapsed  since  the  operation.  Most 
of  the  time  he  has  been  and  still  is  in  Misses  Bancroft  and 
Cox's  School  for  Feeble-minded  Children,  at  Haddonfield, 
New  Jersey.  He  has  had  there  very  painstaking  care,  and 
to  this  is  to  be  attributed  very  much  of  his  mental  improve- 
ment. During  the  last  six  months  of  1892  he  has  had  only 
one  attack  for  about  every  sixty  before  the  operation.  This 
improvement  can  be  attributed  only  to  the  good  effects  of 
the  operation. 

Case  X.  The  last  case  to  which  I  shall  refer  has  not  been 
published,  but  can  be  found  in  the  records  of  the  Ortho- 
pedic Hospital  and  Infirmary  for  Nervous  Diseases  in  Phil- 
adelphia, Record  Book  S.  9,  p.  123.  A  young  girl  of  about 
twenty-one  was  admitted  to  the  infirmary  in  October,  1891, 
She  said  that  her  attacks  of  epilepsy,  from  which  she  had 
suffered  for  two  years  and  a  half,  always  began  in  the  right 
thumb.  This  fact  having  been  verified,  it  was  decided  to 
remove  the  center  for  the  thumb,  for  the  same  reason  as  in 
the  last  case,  i.e.,  to  stop  the  very  beginning  of  the  fit.  It 
was  especially  desired  to  remove  only  the  center  for  the 
thumb,  and  not  that  for  the  hand,  in  order  not  to  interfere 
more  than  was  necessary  with  the  usefulness  of  her  hand, 
upon  which  she  depended  for  her  support,  as  she  was  a  mill- 
girl.  This  was  an  unusual  and  minute  attempt  at  localiza- 
tion, and  a  very  severe  test  of  the  accuracy  of  the  mapping 
of  the  brain  by  vivisection.  On  October  6, 1891,  the  fissure 
of  Rolando  was  first  located,  and  a  disk  of  bone  an  inch  and 
a  half  in  diameter  was  removed,  the  center  of  it  being  two 


AND  MEDICAL  PROGRESS  67 

and  five  eighths  inches  to  the  left  of  the  middle  line.  Both 
the  bone  and  the  brain,  when  exposed,  seemed  to  be  nor- 
mal. The  fissure  of  Rolando  was  seen  crossing  the  middle 
of  the  opening,  downward  and  forward  (Fig  9).  By  the 
battery  the  brain  was  stimulated  at  certain  definite  points 
until  the  thumb   center  was  nssuRpoF- 

recognized,  and  also  the  face  y^ ^^rdiando 

center,  which  lay  somewhat 
below  it,  and  the  wrist  center, 
which  lay  —  as  it  ought  by 
experiments  on  the  monkey's 
brain — a  little  above  it.  Each 
of  these  centers  was  recognized 
by  the  movement  of  the  part 

supplied   by   it    (thumb,    face,  ^^^  ^    ^^^^^    The  circle  rep- 

wrist)    when    the     center    was  resents  the  opening  in  the  skull 

,     J    -          -              ,           J     .r  disclosing  the  thumb  center  al- 

tOUCned    by  the    poles    OI    the  most  at  its  middle.    The  shaded 

hflttPrv  ^timiilntinn  nf  thp  ^'^^^  represents  the  part  of  the 
Dattery.      stimulation    OI    tne       ^rain  which  was  removed. 

thumb  center  produced  a  typi- 
cal epileptic  fit,  such  as  she  had  suffered  from  since  her 
admission,  beginning  in  the  thumb,  as  she  had  asserted. 
The  portion  of  brain  corresponding  to  the  thumb  center,  a 
piece  about  half  an  inch  in  diameter,  was  removed,  and  by 
the  battery  it  was  determined  that  the  portion  removed 
was  the  whole  of  the  thumb  center.  She  recovered  promptly 
and  without  disturbance  from  the  operation. 

It  was  necessary  in  this  case  to  be  unusually  accurate, 
and  not  to  remove  any  portion  of  the  brain  other  than  the 
center  for  the  thumb,  and  for  three  reasons:  First,  if  too 
much  were  removed  upward  and  backward,  the  wrist  and 
fingers  would  be  paralyzed;  second,  if  too  much  were  re- 
moved forward,  the  muscles  of  the  face  would  be  involved; 
third,  a  little  further  down  lies  the  center  for  speech,  and 
had  this  part  of  the  brain  been  injured,  this  important  fac- 
ulty would  have  been  destroyed,  thus  producing  serious  and 
unnecessary  trouble. 


68  ANIMAL  EXPERIMENTATION 

Note  now  the  accuracy  of  experimental  cerebral  localiza- 
tion. As  soon  as  the  patient  had  recovered  from  the  ether 
and  was  in  a  suitable  condition,  her  ability  to  move  the  face 
and  hand  was  tested.  All  the  muscles  of  the  face  were  en- 
tirely intact,  and  could  be  moved  with  absolute  ease.  Her 
speech  also  was  unaffected.  She  had  absolute  and  perfect 
control  of  all  the  muscles  of  the  shoulder,  elbow,  wrist,  and 
hand,  with  the  single  exception  of  the  muscles  of  the  thumby 
every  one  of  which  was  paralyzed.  In  order  to  understand 
how  curious  this  paralysis  is  in  relation  to  the  thumb  center 
in  the  brain,  the  reader  must  observe  that  only  a  small  piece 
of  the  brain,  half  an  inch  square,  was  removed,  whereas  the 
muscles  of  the  thumb  lie  as  follows:  some  of  them  in  the 
ball  of  the  thumb  on  the  hand,  one  between  the  thumb  and 
forefinger,  one  on  the  front  of  the  forearm  reaching  almost 
to  the  elbow  (the  great  flexor  of  the  last  joint  of  the  thumb) , 
and  three  of  them  on  the  back  of  the  forearm,  extending 
half-way  from  the  wrist  to  the  elbow;  and  yet  the  removal 
of  so  small  a  portion  of  the  brain  paralyzed  these  muscles 
of  both  widely  different  situation  and  widely  differing  func- 
tions (flexion,  extension,  abduction,  adduction,  and  cir- 
cumduction) . 

By  June,  1892,  she  had  entirely  recovered  the  use  and 
strength  of  her  thumb,  as  shown  by  the  dynamometer, 
both  sides  then  registering  the  same  number  of  degrees. 

This  history  illustrates  one  of  the  most  curious  problems 
of  cerebral  surgery.  The  removal  of  any  portion  of  the 
motor  region  of  the  brain  is,  of  course,  followed  by  palsy  of 
the  part  of  the  body  supplied  by  that  brain  center;  but 
though  I  have  frequently  removed  portions  of  the  brain, 
I  have  never  yet  seen  this  paralysis  permanent.  I  have  seen 
a  right  hand  wholly  paralyzed  after  such  an  operation,  and 
in  three  months  it  had  regained  its  strength  and  dexterity 
sufficiently  to  enable  its  owner  to  play  baseball.  But  while 
this  is  true  of  the  careful  removal  of  small  parts  of  the 
brain  by  operation,  the  widespread  injuries  which  result 


AND  MEDICAL  PROGRESS  69 

from  accident  are  not  seldom  followed  by  extensive  palsies 
which  remain  throughout  life.  In  the  case  just  related  not 
only  has  strength  returned  equally,  but  such  delicate  move- 
ments as  are  involved  in  the  use  of  a  needle  have  been  pre- 
served, or  rather  restored.  Usually,  however,  weakness,  to 
a  greater  or  less  extent,  will  remain  in  the  part  of  the  body 
controlled  by  the  portion  of  brain  removed.  Whether  there 
is  actual  reproduction  of  brain  tissue  or  not  i«s  as  yet  uncer- 
tain, because  after  such  operations  there  have  been  almost 
no  deaths  at  a  period  sufficiently  remote  to  enable  us  by 
post-mortem  examination  to  determine  whether  such  a  re- 
production has  occurred  or  not.  It  is  possible  that  the  sim- 
ilar center  on  the  opposite  side  of  the  head  is  capable  of  do- 
ing double  duty;  for  although  normally  the  right  side  of  the 
brain  controls  and  moves  the  left  side  of  the  body,  and  vice 
versa,  yet  apparently  there  is  a  latent  power  which  when 
necessary  is  called  into  play,  and  enables  the  right  side  of 
the  brain  to  innervate  and  control  the  same  side  of  the 
body  as  well  as  the  opposite  side,  just  as,  for  instance,  the 
left  hand,  which  is  unused  to  writing,  can  acquire  the  fac- 
ulty of  writing  if  the  right  hand  is  lost. 

There  has  also  been  performed  a  very  remarkable  opera- 
tion on  animals  which  may  hereafter  produce  important 
results.  Several  experimenters  have  opened  the  heads  of 
two  dogs  (both  under  an  anesthetic,  and  both  as  carefully 
and  as  tenderly  cared  for  as  any  human  being  could  be,  the 
operations  being  attended  with  but  little  pain,^  as  they 
were  done  with  the  most  careful  antiseptic  precautions), 
have  taken  a  bit  of  the  brain  from  the  head  of  each  dog  and 
transferred  it  to  that  of  the  other  dog.  The  pieces  so  trans- 
ferred have  grown  in  place,  and  have  caused  at  least  no 
mischief.  Whether  it  will  ever  be  possible  to  transfer  brain 

*  Most  operations  on  the  brain  are  followed  by  very  little  pain,  and 
sometimes  it  may  truthfully  be  said  by  none.  It  is  not  an  uncommon  re- 
sult for  the  patient  to  take  no  medicine,  or  at  most  a  single  small  dose  of 
an  anodyne  on  the  first  day,  be  out  of  bed  in  three  to  five  days,  and  entirely 
well  in  a  week  or  ten  days. 


70  ANIMAL  EXPERIMENTATION 

tissue  from  the  lower  animals  to  man,  and  whether  if  so 
transferred  it  will  properly  perform  its  function,  are  prob- 
lems as  yet  unsolved.  It  would  be,  I  think,  unwise  to  test 
its  effects  in  man  except  as  applied  only  to  the  motor  re- 
gions at  first,  for  we  have  every  reason  to  believe  that  the 
motor  cells  in  an  animal's  brain  subserve  precisely  the 
same  function  as  the  motor  cells  in  the  human  brain.  More- 
over, nothing  of  this  kind  would  ever  be  done  excepting 
perhaps  in  case  of  an  accident  where  a  considerable  portion 
of  the  human  brain  was  destroyed,  when  possibly  this  loss 
could  be  made  good  from  an  animal's  brain.  It  is  unneces- 
sary, however,  to  discuss  this  question  at  present,  for  all 
the  facts  in  the  case,  the  needful  precautions  to  be  taken, 
and  all  the  possible  results,  must  first  be  determined  in 
much  greater  detail  and  by  much  larger  experimentation  on 
animals  than  has  yet  been  done  before  it  will  ever  be  con- 
sidered in  man.  But  it  is  not  at  all  impossible  that  in  this 
way  we  may  see  hereafter  one  of  the  most  brilliant  achieve- 
ments of  modern  cerebral  surgery.^ 

But  we  must  return  again  to  our  last  patient,  for  her  sub- 
sequent history  as  to  her  epilepsy  is  quite  as  interesting  as, 
and  to  her  no  doubt  even  more  important  than,  the  con- 
dition of  her  thumb.  On  December  17,  1891,  seven  weeks 
after  the  operation,  she  had  one  slight  attack.  January  13 
and  30,  1892,  there  were  two;  then  none  until  March  12; 
a  very  slight  one  came  on  May  19;  and  the  last  to  date 
were  two  on  July  8  (slight)  and  10,  making  in  all  seven 
attacks  in  eight  months.  Thus  the  intervals  were  growing 
longer,  and  the  attacks  as  a  rule  less  severe,  while  before 
the  operation  the  attacks  were  growing  more  severe  and 
far  more  frequent,  for  when  she  entered  the  infirmary  they 
were  tending  to  become  daily.^ 

1  So  far  (1914)  no  progress  has  been  made  in  this  direction.  The  value 
of  the  experimental  research  in  animals  in  preventing  such  dangerous 
attempts  in  human  beings  is  evident. 

2  Since  this  was  written  her  attacks  have  become  somewhat  more  fre- 
quent, but  are  still  far  less  frequent  and  severe  than  before  the  operation. 


AND  MEDICAL  PROGRESS  71 

The  anti-vivisectionists  constantly  parade  the  few  phy- 
sicians who  are  in  accord  with  their  views,  and  by  frequent 
reappearances  make  an  apparent  army  upon  the  stage.  As 
a  matter  of  fact,  Mr.  Lawson  Tait  is  the  only  one  who  has 
an  international  reputation;  the  rest  are  but  little  known. 
Even  Mr.  Tait  recently  changed  his  views,  and  in  a  speech 
in  favor  of  the  objects  of  the  British  Institute  of  Preventive 
Medicine,  which  are  largely  attained  through  vivisection, 
has  declared:  "bacteriological  experiments  on  animals 
have  proved  of  great  value."  What  the  real  opinion  of  the 
medical  profession  of  Great  Britain  is  as  to  the  value  of 
vivisection  is  seen  by  the  following  resolution,  which  was 
passed  in  August,  1892,  at  the  Nottingham  meeting  of  the 
British  Medical  Association,  and  passed  unanimously. 
The  weight  of  such  an  authority  can  best  be  measured  when 
I  state  that  it  is  the  largest  and  most  important  association 
of  physicians  in  the  world,  and  numbers  over  fifteen  thou- 
sand members,  including  most  of  the  distinguished  men  of 
the  profession  in  Great  Britain. 

Resolved,  That  this  general  meeting  of  the  British  Medical 
Association  records  its  opinion  that  the  results  of  experiments  on 
living  animals  have  been  of  inestimable  service  to  man  and  to  the 
lower  animals,  and  that  the  continuance  and  extension  of  such 
investigations  is  essential  to  the  progress  of  knowledge,  the  relief 
of  suffering,  and  the  saving  of  life. 

I  have  thought  it  worth  while  not  to  content  myself  with 
broad  assertions  that  experimentation  on  animals  has  en- 
abled us  to  locate  with  absolute  accuracy  the  various  motor 
functions  and  to  some  extent  the  other  functions  of  the 
brain;  but  to  any  doubting  Thomas  I  would  simply  say. 
See  any  brain  operation  of  this  character,  and  you  cannot 
fail  to  be  convinced  of  its  humanity  and  propriety. 


THE  PROGRESS  OF  SURGERY  AS 
INFLUENCED  BY  VIVISECTION  ^ 

I  HAVE  been  asked  by  the  editor  of  the  Philadelphia 
"Record"  to  write  a  brief  resume  of  the  influence  of  vivi- 
section on  the  progress  of  modern  surgery.  I  shall  do  so  as 
briefly  as  I  possibly  can,  stating  only  facts  which  are  gener- 
ally well  known  to  surgeons,  but  of  which  the  general  pub- 
lic of  necessity  must  be  ignorant  to  a  great  extent.  Most 
of  the  facts  below  stated  are  known  to  me  personally,  as 
they  have  occurred  during  my  professional  lifetime;  and  I 
can,  therefore,  vouch  for  their  accuracy. 

If  a  physiologist  were  asked  to  contribute  a  similar  paper, 
he  would  be  able  to  tell  a  similar  story  as  to  the  revelations 
of  the  functions  of  various  organs  in  the  human  economy 
obtained  through  vivisection;  if  a  professor  of  pharmacol- 
ogy (i.e.,  the  action  of  drugs  upon  the  living  body)  were  to 
write  a  similar  paper,  he  would  be  able  to  show  an  equal 
debt  owing  to  animal  experimentation,  first,  in  giving  us  an 
exact  knowledge  of  the  action  of  drugs,  and,  secondly,  in 
the  introduction  of  a  large  number  of  new  drugs.  In  this 
way  cocain  was  introduced  into  medicine  and  the  proper 
use  of  such  a  powerful  drug  as  digitalis  was  shown. 

If  a  medical  man  were  to  write  a  similar  chapter,  he 
would  scarcely  know  where  to  begin.  The  whole  life  his- 
tory, for  example,  of  the  trichina  has  been  studied  in  ani- 
mals and  the  results  applied  to  man,  so  that  if  every  one 
would  heed  the  warning,  no  one  need  die  from  the  trichina 
worm  in  pork.  This  has  had  also  an  enormous  commercial 
value,  since  all  our  hog  products  are  exported  on  condition 
that  the  trichina  be  excluded  by  microscopical  examina- 

1  Reprinted  by  permission  from  the  Philadelphia  Record  of  September 
14  and  21,  1901.  ' 


MEDICAL  PROGRESS  73 

tion.  In  diphtheria  the  percentage  of  deaths  has  been  re- 
duced in  Baltimore  from  about  seventy  per  cent  to  about 
five  per  cent.  The  saving  of  human  hfe  in  a  single  year  in 
New  York  has  been  1500.  All  this  is  due  to  the  antitoxin 
of  diphtheria,  which  has  been  evolved  solely  as  a  result  of 
animal  experimentation.  .  .  . 

On  the  border  line  between  medicine  and  surgery  is  the 
new  science  of  bacteriology.  In  surgery  this  has  shown  the 
cause  of  inflammation,  of  erysipelas,  of  tetanus  or  lockjaw, 
of  glanders,  of  tuberculosis  (not  only  of  the  lungs,  but  of 
the  brain,  the  bones,  the  joints,  the  bowels,  etc.)  and  of 
many  other  disorders. 

Let  me  give  one  illustration  of  the  method  by  which  the 
cause  of  one  disease  —  tuberculosis  —  was  proved.  Simi- 
lar methods  are  employed  in  tracing  the  causes  of  others. 
In  a  case  of  consumption  of  the  lungs  the  expectoration 
is  examined  by  the  microscope  after  applying  a  staining 
material.  Without  staining,  the  tubercle  bacilli  are  so  trans- 
lucent (like  little  rods  of  jelly)  that  we  can  scarcely  see 
them.  Having  found  this  peculiar  germ  in  the  expectora- 
tion, some  of  the  material  is  injected  under  the  skin  of  a 
guinea  pig.  After  a  certain  time  the  animal  either  dies  or  is 
killed,  and  a  post-mortem  examination  is  made.  If  there 
are  found  in  the  body  of  the  guinea  pig  little  nodules, — 
i.e.,  tubercles  (little  tubers), —  these  are  examined  by  the 
same  method,  and  the  same  germs  will  be  discovered  and 
can  be  obtained  in  a  pure  culture.  But  the  circle  of  proof 
is  not  yet  complete.  A  small  portion  of  this  pure  culture  of 
the  germs  obtained  from  the  inoculated  guinea  pig  is  again 
injected  into  another  animal,  and  if  the  second  animal  suffer 
from  a  similar  disease  and  the  same  germ  be  found  again, 
the  conclusion  is  irresistible  that  the  cause  of  the  tubercu- 
losis is  the  peculiar  germ  always  found  in  such  cases.  ^ 

I  well  remember  the  incredulity  with  which  I  first  read 

*  Yet  the  antivivisectionists  deny  in  toto  this  and  all  other  findings  of 
bacteriology. 


74  ANIMAL  EXPERIMENTATION 

of  the  origin  of  lockjaw  from  the  soil,  but  very  soon^this 
incredulity  was  changed  to  belief  in  the  face  of  absolute 
demonstration  after  this  fashion:  It  had  been  well  known 
for  years  that  hostlers,  cavalrymen,  farmers,  and  persons 
who  were  engaged  in  any  occupation  about  horses  were 
peculiarly  liable  to  lockjaw.  After  the  discovery  of  the 
bacillus  of  lockjaw  in  1884,  by  Nicolaier,  when  a  case  of 
lockjaw  occurred,  the  ground  on  which  the  patient  had 
fallen,  or  the  instrument  by  which  he  had  been  hurt,  was 
examined,  and  a  certain  bacillus  was  found  in  or  on  it. 
This  was  inoculated  into  animals,  and  was  found  to  pro- 
duce the  same  disorder;  and  the  same  bacillus  was  recovered 
from  the  animaFs  body,  and  was  successfully  reinoculated. 
The  circle  of  proof,  therefore,  was  complete.  This  explained 
the  popular  belief  that  treading  on  a  rusty  nail  is  a  fre- 
quent cause  of  lockjaw;  not  because  it  was  a  nail  or  old  or 
rusty,  but  because  the  germ  of  lockjaw  was  on  it  and  in  the 
ground  in  which  it  was  lying.  No  such  exact  experiments 
are  justifiable  on  man.  The  sacrifice  of  a  few  rats  quickly 
gave  us  all  the  desired  information.  This  has  almost 
totally  abolished  lockjaw  as  a  result  of  surgical  operations, 
and  enabled  us  to  cure  it  in  many  cases  even  after  acci- 
dental inoculation.  Before  1884  it  was  both  frequent  and 
fatal;  now  it  is  almost  a  surgical  curiosity,  except  after 
neglected  accidents. 

The  two  most  important  surgical  discoveries  of  the  nine- 
teenth century  were,  (1)  anesthesia,  especially  by  ether  (in 
1846)  and  by  chloroform  (in  1847) ;  and  (2)  antisepsis,  by 
Lord  Lister,  who  began  his  work  soon  after  the  middle  of 
the  nineteenth  century  and  had  distinctly  formulated  it 
about  the  end  of  the  sixties.  His  remarkable  paper  in 
"The  Lancet"  of  April  3,  1869  (when  he  was  simply  Mr. 
Lister,  Professor  of  Surgery  in  the  University  of  Glasgow), 
was  one  of  those  papers  which  marked  a  new  era  in  surgery. 
Several  years  before,  he  had  announced  that  he  believed 
that  inflammation  and  most  of  our  surgical  disorders  were 


AND  MEDICAL  PROGRESS  75 

due  to  germs,  and  that  if  we  could  exclude  these  germs,  we 
would  be  able  to  secure  the  healing  of  wounds  without  in- 
flammation and  without  the  formation  of  pus  (matter); 
yet  it  was  not  until  1881  that  Ogston  and  Rosenbach  dis- 
covered the  germs  which  produce  the  terrible  results  of 
inflammation,  such  as  erysipelas,  hospital  gangrene  (what 
irony  in  the  name!)  abscesses,  blood  poisoning  and  even 
death. 

Hemorrhage 

One  of  the  most  important  contributions  by  Lister  to  the 
progress  of  surgery  was  the  introduction  of  antiseptic 
threads  (ligatures)  of  catgut,  with  which  to  tie  blood- 
vessels. One  of  the  earliest  Philadelphia  surgeons,  Philip 
Syng  Physick,  tried  to  get  rid  of  the  dangers  following  silk, 
which  had  been  used  to  tie  arteries  ever  since  Ambroise 
Pare  introduced  it  in  the  sixteenth  century  as  a  happy  sub- 
stitute for  the  horrible  hot  pitch  and  hot  iron  which  then 
were  the  only  means  for  arresting  hemorrhage.  Physick 
sought  to  use  buckskin,  on  the  ground  that  it  was  an  ani- 
mal substance  and  would,  therefore,  disappear  by  absorp- 
tion. Dorsey  used  catgut.  Hartshorne  used  parchment 
cut  in  fine  threads,  and  Bellinger  and  Eve  the  tendon  of  the 
deer.  But  none  of  these  surgeons  succeeded  in  giving  us 
harmless  ligatures  until  Lister  taught  us  how  to  use  them. 
In  the  paper  which  I  have  referred  to  he  showed  that  the 
old  idea  of  a  ligature  was  that  it  was  a  foreign  body  which 
was  to  be  got  rid  of  by  its  rotting  through  the  walls  of  the 
blood-vessel.  The  result  was  that  in  a  very  large  percent- 
age of  cases  the  blood-vessel  was  not  stopped  by  a  clot;  sec- 
ondary hemorrhage  took  place  (usually  during  the  second 
week  after  an  operation),  and  many  a  patient  bled  to 
death. 

I  shall  never  forget  one  night  in  the  Satterlee  Hospital, 
of  West  Philadelphia,  about  ten  days  after  the  battle  of 
Gettysburg,  when  I  was  called  five  times  to  check  just 


76  ANIMAL  EXPERIMENTATION 

such  secondary  hemorrhage  from  the  rotting  through  of 
silk  ligatures.  As  a  consequence  of  the  introduction  of  anti- 
septic ligatures  by  Lister  I  do  not  recall  in  the  last  thirty 
years  five  cases  similar  to  these  five  that  I  then  attended  in 
one  night.  In  other  words,  secondary  hemorrhage  has  al- 
most disappeared  from  surgical  experience. 

How  did  Lister  find  out  the  proper  method  of  tying  an 
artery?  On  December  12,  1867,  he  tied  the  great  carotid 
artery  in  the  neck  of  a  horse  with  a  piece  of  pure  silk  satur- 
ated with  a  strong  watery  solution  of  carbolic  acid,  cutting 
both  ends  of  the  thread  short  and  dressing  the  wound  anti- 
septically.  Healing  took  place  without  any  inflammation. 
Thirty-nine  days  after  the  operation  he  investigated  the 
parts  by  dissection,  and  found  that  if  the  thread  had  not 
been  applied  with  the  antiseptic  precautions,  secondary 
hemorrhage  would  unquestionably  have  occurred,  and  in 
all  probability  the  animal  would  have  bled  to  death.  On 
January  29,  1868,  he  applied  this  principle  in  the  case  of  a 
woman  of  fifty-one  with  an  enormously  dilated  sac  (an 
aneurism)  in  the  upper  part  of  the  great  artery  supplying 
the  thigh  and  leg.  She,  like  the  horse,  recovered  without 
inflammation,  and  lived  for  ten  months.  On  November  30 
she  suddenly  died  as  the  result  of  a  rupture  of  a  similar 
dilatation  of  the  aorta  in  the  chest.  This  gave  Lister  the 
unusual  opportunity  of  examining  in  a  human  body  the 
result  of  his  application  of  an  antiseptic  thread  to  the  ar- 
teries. The  case  emphasizes  one  of  the  great  difficulties  in 
studying  such  questions  on  human  beings.  The  opportu- 
nity for  a  post-mortem  examination  after  such  an  application 
of  a  new  principle  can  only  be  occasional.  If  this  woman  at 
the  time  of  her  death  had  been  under  the  care  of  some  other 
surgeon  than  Lister,  no  such  careful  examination  of  the  con- 
sequences of  the  tying  of  the  artery  would  have  been  made, 
and  no  further  progress  would  have  followed.  The  result 
of  Lister's  examination  showed  that,  in  spite  of  his  care,  an 
incipient  abscess  was  developing  at  the  point  at  which  he 


AND  MEDICAL  PROGRESS  77 

had  tied  the  artery.  This  was  in  consequence  of  the  presence 
of  the  thread,  and  especially  of  the  knot. 

As  a  result  of  this  investigation,  on  December  31,  1868, 
he  tied  the  carotid  artery  in  the  neck  of  a  calf  with  catgut 
which  had  been  prepared  with  carbolic  acid,  and  all  anti- 
septic precautions  were  used  during  the  operation.  The 
calf  recovered  perfectly,  and  in  thirty  days  was  killed  and 
the  parts  dissected.  He  found  that  at  the  site  of  the  thread 
of  catgut  there  was  a  band  of  living  tissue  surrounding  the 
thread  and  closing  the  artery,  and  that,  therefore,  instead 
of  the  thread  rotting  through,  as  was  the  case  with  the  silk, 
it  had  become  a  part  and  parcel  of  the  tissues.  The  artery, 
instead  of  being  so  weakened  as  to  allow  of  secondary 
hemorrhage,  was  really  stronger  at  this  point  than  at  other 
points.  The  ligature  and  the  knot  had  entirely  disappeared. 

I  have  narrated  this  somewhat  in  detail  for  this  reason: 
It  illustrates  admirably  the  method  of  scientific  progress  by 
experiment  upon  animals.  Neither  of  these  animals  suf- 
fered any  material  pain,  both  operations  having  been  done 
with  the  same  antiseptic  care  as  in  a  human  being.  Both 
of  them  were  killed  at  such  a  time  as  would  facilitate  our 
knowledge  of  the  results. 

Since  then  other  experimenters  have  tied  the  blood-ves- 
sels in  animals  and  have  killed  them  at  varying  intervals 
and  made  microscopical  examinations  of  the  blood-vessels. 
In  this  manner  our  knowledge  of  the  way  in  which  hemor- 
rhage is  stopped  is  now  complete.  The  knowledge  which 
was  attained  within  a  short  time  by  the  sacrifice  of  a  few 
animals  would  have  been  attained  only  after  many  years 
by  occasional  post-mortems,  and  would  then  have  been 
very  much  less  perfectly  attained  and  only  by  the  loss  of 
many  human  lives  instead  of  a  few  animals'  lives. 

Contrast,  now,  the  result  of  the  old  and  the  new  surgery 
in  the  mere  matter  of  stopping  hemorrhage  after  opera- 
tions or  accident  by  tying  blood-vessels  with  the  old  ordin- 
ary silk  and  the  modern  antiseptic  catgut,  or  with  silk  itself 


78  ANIMAL  EXPERIMENTATION 

as  now  used  by  improved  methods.  In  the  old  way  the 
blood-vessels  were  tied  with  silk,  which  was  as  clean  as  an 
ordinary  housewife  would  have  it.  One  end  was  left  long, 
and  it  was  no  uncommon  thing  after  an  amputation  of  the 
thigh  to  have  as  many  as  twenty  or  thirty  of  these  ligatures 
or  threads  hanging  out  of  the  wound.  After  two  or  three 
days,  when  those  on  the  smaller  blood  vessels  would,  pos- 
sibly have  rotted  through,  each  ligature  was  pulled  upon, 
and  those  that  were  already  loosened  by  putrefaction  came 
away.  Finally,  at  the  end  of  ten  days,  two  weeks,  or  three 
weeks,  the  ligature  on  the  great  blood-vessel  of  the  arm  or 
thigh  came  away,  not  uncommonly  followed,  as  has  been 
stated,  by  profuse  and  often  fatal  hemorrhage.  Sometimes, 
as  in  Lord  Nelson's  case,  such  a  ligature  did  not  rot  away 
for  years,  and  required  dressing  of  the  arm  all  of  this  time 
on  account  of  the  constant  discharge. 

What  happens  to-day  in  a  surgical  operation  where 
either  properly  prepared  silk  or  catgut  is  used?  We  tie  all 
the  blood-vessels  needing  it,  cut  off  both  ends  of  the  threads 
short  and  close  the  wound  entirely;  and,  instead  of  having 
discharge  and  horrible  inflammation  for  days  and  often 
weeks  and  sometimes  months,  it  is  now  a  rare  thing  for 
such  a  wound  not  to  be  entirely  healed  within  ten  days,  and 
sometimes  less,  and  secondary  hemorrhage  is  almost  un- 
heard of.  If  vivisection  had  given  to  surgery  only  the  mod- 
ern means  of  stopping  hemorrhage,  it  would  be  worth  all 
the  labor  it  has  required  and  all  the  suffering  it  has  inflicted 
on  all  the  animals  ever  experimented  upon. 

Of  late  a  new  problem  in  hemorrhage  has  been  presented. 
When  an  artery  is  wounded  —  as,  for  instance^  if  the  blade 
of  a  pocket  knife  has  been  thrust  into  the  thigh  and  wounds 
the  great  femoral  artery  —  the  only  way  to  prevent  the 
patient's  bleeding  to  death  has  been  to  expose  the  artery 
and  tie  it  above  and  below  the  point  where  it  was  cut.  Of 
late  several  surgeons  (especially  Murphy,  of  Chicago)  have 
made  some  very  ingenious  experiments  on  such  wounded 


AND  MEDICAL  PROGRESS  79 

blood-vessels.  They  have  carefully  exposed  the  artery  of 
an  animal  (under  an  anesthetic,  of  course),  have  wounded 
it,  and  then,  instead  of  tying  the  artery,  have  sewed  up  the 
wound  in  the  wall  of  the  artery  to  see  whether  this  could 
not  be  done  successfully.  The  reason  for  this  series  of  ex- 
periments is  this:  When  we  cut  off  the  supply  of  blood  to  a 
leg  or  an  arm  by  tying  the  blood-vessels,  gangrene  not  un- 
commonly occurs,  because  the  chief  blood-supply  of  the 
limb  is  cut  off  by  tying  the  artery.  If  instead  of  tying  the 
vessel  we  can  sew  up  the  wall  and  it  will  heal,  the  current 
of  blood  is  uninterrupted  and  there  is  no  danger  of  gan- 
grene. One  thing  is  perfectly  manifest  —  it  would  never 
be  proper  to  make  such  experiments  on  human  beings. 
Human  life  would  be  endangered,  and  no  surgeon  would 
adopt  or  would  be  justified  in  adopting  such  a  novel  pro- 
cedure until  it  had  been  tried  and  proved  successful  on 
animals.  Several  successful  cases  of  suture  (sewing)  of  the 
large  blood-vessels  have  now  been  done  in  man.^ 

The  Brain 

When  I  first  taught  anatomy,  thirty-five  years  ago,  the 
various  portions  of  the  brain  were  not  supposed  to  have 
separate  functions.  We  knew,  of  course,  that  disease  or  an 
injury  on  one  side  of  the  head  produced  paralysis  on  the  op- 
posite side  of  the  body.  Broca  also  discovered  by  observa- 
tions on  man  in  actual  cases  of  disease  that  when  that  part 
of  the  brain  corresponding  to  the  left  temple  was  affected 
the  power  of  speech  was  lost.  But  if  a  man  had  a  fracture 
of  the  skull  or  a  gunshot  wound  in  the  region  above  the  ear 
or  in  the  front  of  the  brain  or  the  back  of  the  brain,  there 
was  no  well-recognized  difference  in  the  results.  This  was 
largely  due  to  the  fact  that  such  injuries  are  widespread, 
and  not  limited  to  small  areas.  In  Germany,  Fritsch,  Hit- 
zig,  and  Goltz,  and  in  England,  Horsley,  Ferrier,  Schaeffer, 

^  Now  some  hundreds  of  cases  have  been  successfully  operated  on  and 
patients  doomed  to  lose  leg  or  life  have  had  both  preserved.     (1914.) 


80  ANIMAL  EXPERIMENTATION 

and  others,  pursued  the  following  plan:  The  monkey's 
brain  is  the  nearest  in  similarity  to  man's.  A  known  por- 
tion of  the  brain  —  for  instance,  the  region  above  the  ear  — 
being  exposed,  the  brain  was  mapped  out  in  small  squares, 
and  each  one  of  these  squares  in  succession  had  the  pole  of 
a  battery  applied  to  it.  The  phenomena  which  occurred  — 
whether  opening  and  shutting  the  eyes,  turning  the  head 
right  or  left,  contraction  of  the  muscles  of  the  arm  or  leg  — 
were  all  carefully  noted  down.  In  this  way  a  distinct  map 
of  the  brain  was  made,  so  that  we  know  definitely  that  a 
certain  area  of  the  surface  of  the  brain  governs  the  move- 
ments of  the  eyes,  of  the  head,  of  the  arm,  forearm,  hand, 
thumb,  thigh,  leg,  great  toe,  etc.  In  the  same  way  at  the 
back  of  the  head  the  area  which  governs  sight  has  been 
found,  and  it  was  discovered  that  the  area  on  the  right  side 
if  destroyed  made  the  right  half  of  each  eye  blind,  and  that 
if  the  area  of  the  left  side  was  destroyed,  the  left  half  of 
each  eye  became  blind.  This  description  is,  probably,  suJ05- 
cient  to  indicate  how  physiologists  and  surgeons  have  in- 
vestigated the  brain. 

The  following  is  an  instance  which  shows  how  accurately 
this  method  has  enabled  us  to  locate  the  motor  centers  in 
the  brain.  A  girl,  who  suffered  from  epilepsy,  and  in  whom 
the  convulsions  always  began  in  the  right  thumb,  and  then 
spread  to  the  arm  and  the  body,  was  operated  upon.  A 
piece  of  the  gray  matter  on  the  surface  of  the  brain,  as 
large  as  the  last  joint  of  the  forefinger,  was  removed  from 
the  place  determined  upon  animals  as  the  center  govern- 
ing the  movements  of  this  thumb.  When  she  awoke  from 
the  ether  that  thumb  but  no  other  part  of  the  body  was  en- 
tirely paralyzed.  When  we  remember  that  the  muscles 
which  move  the  thumb  arise  in  the  ball  of  the  thumb, 
between  the  thumb  and  the  forefinger,  and  on  the  front 
and  the  back  of  the  forearm  nearly  as  high  as  the  elbow, 
this  is  seen  to  be  most  remarkable.  I  do  not  know  a  sin- 
gle case  ever  recorded  of  so  minutely  located  disease.   By 


AND  MEDICAL  PROGRESS  81 

no  other  means  than  vivisection  could  this  small  thumb 
center  have  been  determined.  She  has  entirely  recovered 
from  the  paralysis,  and  her  epileptic  fits  instead  of  being 
almost  daily  were  reduced  to  one  or  at  the  most  two  a 
year. 

Those  experiments  have  made  possible  the  modern  sur- 
gery of  the  brain,  which  would  not  exist  to-day  were  it  not 
for  vivisection.  .  .  . 

It  is  a  source  of  sincere  gratification  on  the  part  of  nu- 
merous surgeons  that  by  this  same  knowledge  of  cerebral 
localization  derived  from  animal  experimentation  they 
have  been  able  to  recognize  hemorrhage  inside  the  skull, 
open  the  skull  at  the  right  point,  even  when  there  was  no 
fracture  of  the  skull,  and  save  their  patients.  Before  exper- 
iments on  animals  showed  us  how  to  interpret  the  symp- 
toms this  was  an  impossibility,  and  nearly  all  such  patients 
died.  Now  we  save,  roughly  speaking,  two  out  of  three! 

Time  and  space  would  fail  me  to  tell  of  the  abscesses  of 
the  brain,  of  the  foreign  bodies  in  the  brain  (such  as  nails 
driven  into  it  by  accident  or  desigD,  rifle-balls  which  had 
lodged  in  it),  and  of  many  other  similar  surgical  disorders 
the  modern  successful  treatment  of  which  depends  di- 
rectly upon  the  localization  of  cerebral  functions,  which 
is  the  result  almost  wholly  of  experiments  upon  animals. 

The  Spinal  Cord 

Up  to  the  present  time  the  belief  of  surgeons  has  been 
that  in  case  the  spinal  cord  was  completely  cut  in  two, 
either  by  gunshot  wounds,  fracture  of  the  spine  or  other- 
wise, no  reunion  of  the  two  ends  would  take  place,  and, 
therefore,  there  was  no  possibility  of  relief  for  the  paralysis 
below  the  point  of  division  of  the  cord  which  is  almost 
always  fatal.  Only  this  winter,  at  the  Pennsylvania  Hos- 
pital, Dr.  F.  T.  Stewart  had  a  patient  whose  spinal  cord 
was  cut  in  two  by  a  bullet.  He  removed  the  bone  suffi- 
ciently to  get  access  to  the  spinal  cord,  and  found  it  com- 


82  ANIMAL  EXPERIMENTATION 

pletely  divided.  He  immediately  stitched  the  two  ends  to- 
gether, and,  strange  to  say,  this  patient  has  recovered  both 
feeling  and  motion  to  some  extent  in  both  legs.  I  think 
it  would  be  evident  to  any  person  that  such  a  totally  unex- 
pected result  deserves  the  most  careful  investigation.  In 
man  cases  of  such  complete  division  followed  by  recovery 
are  almost  unknown;  and  if  they  had  to  be  studied  in  man, 
this  would  be  imperfectly  done,  and  probably  would  require 
fifteen  or  twenty  years  before  we  would  know  what  ought 
to  be  done.  It  is  one  of  those  cases  in  which  it  is  our  duty 
to  investigate  by  experiments  upon  animals  what  is  the 
best  method  of  sewing  the  two  ends  of  the  spinal  cord  to- 
gether; at  what  date  after  division  of  the  cord  it  will  be 
hopeless  to  do  so;  how  much  of  the  cord  can  be  lost  (that  is 
to  say,  a  half  inch,  or  more)  and  yet  by  stitching  the  two 
ends  together  it  will  be  possible  to  restore  the  function  of 
the  spinal  cord.  One  can  see  very  readily  that  in  animals 
all  these  problems  can  be  studied  minutely,  in  a  sufficient 
number  of  cases;  various  procedures  can  be  tested  and  the 
results  determined  accurately  by  killing  such  animals  at  a 
suitable  date,  and  a  definite  conclusion  can  be  reached  in  a 
short  time. 

In  1888  Mr.  (now  Sir  Victor)  Horsley,  the  distinguished 
London  surgeon,  and  Dr.  Gowers,  equally  distinguished  as 
a  neurologist,  for  the  first  time  in  the  history  of  surgery 
made  a  diagnosis  of  a  tumor  of  the  spinal  cord,  definitely 
located  it  and  the  former  removed  it,  the  patient  making  an 
absolute  recovery.  A  number  of  other  cases  have  been  suc- 
cessfully operated  on  since  then.  Just  as  in  the  case  of  tu- 
mors of  the  brain,  this  would  not  have  been  possible  had  it 
not  been  for  experiments  upon  animals,  which  have  given 
us  practically  most  of  our  present  knowledge  of  the  minute 
anatomy  and  physiology  of  the  spinal  cord  and  have,  there- 
fore, enabled  us  to  deal  with  it  surgically. 


AND  MEDICAL  PROGRESS  83 

Nerves 

Among  the  most  fruitful  branches  of  research  which  have 
been  so  valuable  in  results  are  the  animal  experiments  upon 
the  different  nerves  of  the  body.  The  methods  by  which 
nerves  could  be  sewed  together;  the  possibility  of  taking  a 
portion  of  a  nerve  or  even  of  the  spinal  cord  from  a  rabbit 
or  other  animal  to  replace  a  piece  of  the  nerve  when  it  has 
been  destroyed  by  accident  or  disease;  the  possibility  of 
sewing  one  nerve  to  a  neighboring  nerve  in  order  to  rees- 
tablish its  function  —  all  of  these  and  other  similar  oper- 
ations have  been  studied  in  animals,  and  could  only  be 
studied  in  animals  with  exactness. 

In  order  to  study  such  conditions  it  is  not  enough  that 
the  two  ends  of  the  nerve  should  be  sewed  together  and 
then,  after  the  wound  has  healed,  that  we  should  simply 
determine  the  fact  that  the  functions  of  the  nerve  are  rees- 
tablished. It  is  necessary  to  know  by  the  microscope  the 
various  steps  of  the  process  of  union  of  the  nerves  —  to 
investigate  various  methods  of  sewing  them  together; 
whether  they  can  be  overlapped,  or  must  be  applied  ex- 
actly end  to  end;  whether  one  end  of  the  nerve  can  be  split 
and  the  other  inserted  into  it,  or  turned  over  as  a  flap,  and 
so  on.  Evidently  numerous  methods  can  only  be  studied 
on  animals.  Then,  when  the  results  are  known,  we  can 
apply  them  for  the  benefit  of  man. 

The  Thyroid  Gland 

One  of  the  commonest  diseases  in  Europe,  and  one  that 
is  occasionally  seen  here,  is  goiter.  This  forms  a  large  tu- 
mor in  the  neck,  for  which  formerly  little  could  be  done,  as 
an  operation  was  nearly  always  fatal.  Such  patients  were 
obliged  to  go  through  life  with  a  dreadful  deformity,  in  the 
greatest  discomfort,  and  were  sometimes  suffocated  by  pres- 
sure on  the  windpipe.  In  consequence  of  the  introduction 
of  the  antiseptic  method  of  Lister,  which  we  owe  to  vivi- 


84  ANIMAL  EXPERIMENTATION 

section  more  than  to  any  other  agency,  operations  on  the 
thyroid  gland  are  now  so  common  that  at  the  German  Sur- 
gical Congress  in  April  of  this  year  Professor  Kocher,  of 
Berne,  has  reported  two  thousand  operations  done  by  him- 
self, with  a  mortality  of  only  four  per  cent. 

Very  soon  it  was  discovered  that  removal  of  the  entire 
gland  produced  a  curious  effect.  The  face  became  bloated; 
the  expression  greatly  changed,  and  the  patient  became 
more  or  less  idiotic  —  that  is,  the  condition  known  as  myx- 
edema followed.  This  led  to  improvement  in  operations  in 
several  directions.  First,  in  all  those  cases  in  which  the  tu- 
mor could  be  shelled  out,  as  an  English  walnut  is  turned 
out  of  its  shell,  leaving  a  portion  of  gland  tissue  behind, 
this  was  done.  The  similar  effects  of  the  removal  of  the 
thyroid  in  animals  were  studied  especially  by  Horsley. 
Surgeons  then  removed  the  thyroid  gland  from  the  neck 
of  an  animal  and  placed  it  under  the  skin  of  the  same  ani- 
mal, and  it  was  found  that  the  disastrous  results  were 
avoided.  After  a  number  of  experiments  on  animals  there 
was  good  reason  to  believe  that  the  disastrous  effects  of 
the  operation  which  sometimes  followed  goiter  could  be 
avoided  in  man  by  the  same  procedure.  Accordingly  the 
thyroid  gland  of  a  sheep  was  transplanted  in  a  number  of 
instances  under  the  skin,  or  in  some  cases  into  the  abdom- 
inal cavity.  In  both  cases  there  was  improvement  for  a 
time;  but  eventually  the  majority  of  the  cases  suffered 
from  cretinism  or  myxedema,  which  may  be  described  as  a 
less  severe  form  of  the  same  disease.  Finally,  in  animals  a 
study  was  made  to  determine  how  much  of  the  gland  must 
be  left  in  order  to  prevent  myxedema,  and  now  we  are  able 
to  relieve  patients  from  goiter  and  yet,  by  leaving  enough 
of  the  gland,  prevent  any  bad  results  following  the  opera- 
tion. 

These  results  led  also  to  a  careful  study  of  the  effects  of 
giving  an  extract  of  the  thyroid  gland  to  human  beings. 
Some  of  the  most  brilliant  results  that  have  ever  been  ob- 


AND  MEDICAL  PROGRESS  85 

tained  in  medicine  have  followed  the  administration  of  the 
thyroid  extract  to  cretins  in  whom  the  disease  had  not  been 
produced  by  operations  for  goiter,  but  arose  naturally.  In 
certain  forms  of  goiter  it  has  enabled  us  to  relieve  or  even 
to  cure  without  operation.  In  insanity  and  many  other 
mental  states  it  is  used  as  a  well-established  remedy,  which 
in  even  a  large  percentage  of  cases  is  followed  by  great 
benefit  and  even  by  cure.  In  many  other  diseases  also  the 
thyroid  extract  has  been  used  with  the  best  results.^ 

Removal  of  the  Larynx 

Cancer  of  the  larynx,  or  that  part  of  the  windpipe  back 
of  and  just  below  the  Adam's  apple,  is  not  at  all  uncom- 
mon. The  only  hope  for  such  patients  is  in  removing  the 
entire  larynx  or  voice  box.  Before  attempting  this  for  the 
first  time  on  man,  Billroth,  of  Vienna,  and  his  assistant 
Czerny,  now  the  distinguished  Professor  of  Surgery  at 
Heidelberg,  tested  the  operation  on  several  dogs.  Billroth 
then  removed  the  larynx  from  his  patient  and  saved  his 
life.  This  operation  has  now  been  successfully  repeated 
scores  and  scores  of  times  as  a  result  of  these  few  experi- 
ments on  dogs. 

The  Lungs 

A  beginning  has  been  made  in  the  surgery  of  the  lungs, 
but  as  yet  we  have  not  reached  the  point  where  we  can  say 
that  we  have  attained  entire  success.  In  a  number  of  ani- 
mals parts  of  the  lungs  have  been  cut  out  with  a  view  of  dis- 
covering the  possibility  of  cutting  out  diseased  portions  of 
lung,  the  seat  of  tumors,  consumption  and  other  disorders, 
and  a  few  operations  have  been  done  upon  man,  with  a  fair 
percentage  of  success.  Not  uncommonly  abscesses  of  the 
lungs  which  were  perfectly  inaccessible  a  few  years  ago 
have  been  reached  and  opened.  Sometimes  coins  and  other 

^  For  the  later  discovery  of  the  use  of  the  "parathyroid  glands,"  see 
"Recent  Surgical  Progress,"  post,  p.  166. 


86  ANIMAL  EXPEREMENTATION 

foreign  bodies  get  into  the  bronchial  tubes,  and  can  only  be 
reached  through  most  difficult  and  dangerous  operations. 
Several  surgeons  have  experimented  upon  animals  to  de- 
termine the  safest  method  of  removing  such  bodies,  but 
with  only  partial  success.  Is  it  not  evidently  our  duty  to 
devise  new  operative  procedures  and  test  them  on  animals 
first,  and,  when  a  reasonably  promising  one  has  been  found, 
to  apply  it  to  man?^ 

The  Liver 

In  1890,  Ponfick,  of  Germany,  showed  that  in  rabbits  the 
removal  of  a  quarter  of  the  liver  caused  a  slight  deteriora- 
tion in  the  condition  of  the  animal;  removal  of  one  half 
was  followed  by  much  more  serious  symptoms,  which, 
however,  passed  off  within  a  few  days.  Even  removal  of 
three  fourths  of  the  whole  liver  could  be  recovered  from, 
but  removal  of  more  than  this  was  always  fatal.  By  killing 
the  animal  in  which  a  small  part  had  been  removed  at  a 
suitable  time,  and  studying  microscopically  the  liver  tissue 
at  different  periods  of  time  after  operation  —  a  procedure 
manifestly  only  possible  in  animals  —  he  showed  that  there 
was  a  reparative  power  in  the  liver,  which  before  then  was 
unknown. 

Up  to  that  date  less  than  a  dozen  surgeons  had  operated 
on  tumors  of  the  liver.  In  only  two  of  them  was  any  con- 
siderable portion  of  the  liver  removed.  After  the  paper  by 
Ponfick,  which  showed  how  much  could  be  removed,  sur- 
geons immediately  operated  with  much  more  confidence, 
and  removed  considerable  portions  of  the  liver.  Up  to 
1899  seventy-six  tumors  of  the  liver  had  been  removed. 
Of  these  cases  the  termination  of  two  was  unknown;  of  the 
remaining  seventy-four,  sixty-three  recovered  and  eleven 
died — a  mortality  of  less  than  fifteen  per  cent.  One  who 
is  not  a  surgeon  can  scarcely  appreciate  how  differently 

*  See  the  papers  on  "The  New  Surgery  "  (post,  p.  171)  and  " The  In- 
fluence of  Antivivisection  on  Character  "  (post,  p.  234)  for  the  remark- 
able recent  progress  in  the  surgery  of  the  chest. 


AND  MEDICAL  PROGRESS  87 

the  operation  for  tumor  of  the  liver  was  regarded  before 
and  after  Ponfick's  experiments.  Before  that  everything 
was  marked  by  timidity;  after  that  everything  was  marked 
by  confidence,  and  all  to  the  benefit  of  the  patient. 

The  Spleen 

The  same  story  that  has  been  told  of  the  liver  can  be  told 
of  the  spleen,  though  with  much  less  good  results.  As  a  re- 
sult of  studies,  partly  by  accident,  in  man  (as  when  in  con- 
sequence of  a  stab-wound  or  other  injury  a  spleen  would 
protrude  through  the  wall  of  the  abdomen,  and  would  have 
to  be  removed),  but  chiefly  as  a  result  of  the  careful  studies 
of  removal  of  the  spleen  in  animals,  beginning  practically 
with  Schindeler's  experiments  in  1870,  we  are  now  in  a  posi- 
tion definitely  to  say  that  in  man  the  entire  spleen  can  be 
removed,  and  he  can  not  only  survive  the  operation,  but 
can  get  along  comfortably  without  any  spleen.  A  very  con- 
siderable number  of  such  operations  have  now  been  suc- 
cessfully performed. 

The  Kidney 

On  August  2,  1869,  Professor  Simon,  of  Heidelberg,  laid 
the  foundation  of  the  modern  surgery  of  the  kidney  by  re- 
moving a  healthy  kidney  from  a  healthy  woman.  The  rea- 
son for  it  was  that  in  removing  an  ovarian  tumor  some  time 
before  he  had  been  obliged  to  remove  a  part  of  the  ureter 
(the  tube  leading  from  the  kidney  to  the  bladder),  and  to 
fasten  the  cut  end  to  the  skin.  As  a  consequence  of  this  the 
woman  was  in  a  most  deplorable  condition  from  the  con- 
tinual escape  of  urine  over  her  person.  After  a  number  of 
unsuccessful  attempts  to  close  this  external  opening,  it 
finally  occured  to  him  that  the  only  way  to  cure  her  was  to 
remove  the  kidney  on  that  side.  Whether  a  human  being 
would  recover  and  could  live  with  only  one  kidney  was 
practically  unknown.  It  is  true  that  disease  had  destroyed 
one  kidney  in  some  patients  and  the  other  had  gradually 


88  ANIMAL  EXPERIMENTATION 

developed  ability  to  do  the  work  of  both.  Injury  also  had 
destroyed  parts  or  all  of  one  kidney,  but  deliberately  to 
take  out  a  healthy  kidney  from  a  healthy  human  being  was 
an  operation  not  only  fraught  with  danger,  but  one  before 
which  all  the  surgical  world  up  to  that  time  had  recoiled. 
No  one  had  studied  the  effect  on  the  remaining  kidney  and 
upon  the  heart.  No  one  had  carefully  determined  what  was 
the  best  method  of  reaching  the  kidney  —  whether  through 
the  abdomen  or  through  the  loin  from  the  back;  what  to  do 
with  adhesions  and  many  other  technical  questions.  All 
these  had  to  be  settled.  Accordingly  he  experimented  on  a 
number  of  dogs;  decided  that  from  these  indications  a  hu- 
man being  could  live  with  only  one  kidney;  studied  on  the 
cadaver  the  best  way  of  doing  the  operation,  and  on  August 
2,  1869,  removed  this  healthy  kidney  through  the  loin, 
saved  the  patient's  life  and  made  her  perfectly  comfortable. 
She  died  in  1877,  after  eight  years  of  healthy  life. 

As  I  have  said,  these  new  experiments  laid  the  founda- 
tion of  the  modern  surgery  of  the  kidney.  Now  hundreds 
of  kidneys  have  been  removed  successfully.  Finding  this 
operation  so  feasible,  surgeons  were  led  to  practice  other 
operations;  some  hundreds  of  abscesses  in  the  kidney  have 
been  opened;  stones  have  been  removed  from  scores  of  kid- 
neys; floating  (i.e.,  loose)  kidney  has  been  sewed  fast  in 
hundreds  of  cases;  many  cases  of  tuberculosis  of  the  kidney 
have  been  relieved  or  cured;  tumors  of  the  kidney  are  suc- 
cessfully attacked;  even  the  cut  ureter  has  been  spliced; 
stones  also  have  been  removed  from  it.  In  a  word,  Simon's 
experiments  on  a  few  dogs  opened  to  us  a  new  domain  in 
surgery  which  until  then  was  wholly  unknown.  Would 
it  not  be  gross  cruelty  to  man  to  prevent  such  benefi- 
cent researches? 

The  Stomach 

Were  I  limited  to  the  progress  of  the  surgery  of  the  stom- 
ach alone  by  vivisection  there  would  be  quite  enough  ma- 


AND  MEDICAL  PROGRESS  89 

terial  for  this  entire  paper.  Until  1875  practically  there  was 
no  surgery  of  the  stomach.  As  occasional  Csesarean  sec- 
tions have  been  done  in  the  past,  so  occasional  operations 
on  the  stomach  were  done  when  the  surgeon  was  obliged  to 
do  them.  Now,  however,  it  is  a  matter  of  routine  proced- 
ure, to  the  vast  benefit  of  the  human  race.  Had  vivisection 
contributed  nothing  else  to  the  progress  of  surgery  than  its 
services  in  the  surgery  of  the  stomach,  this  alone  would  be 
suflScient  to  justify  it.  I  may  quote  from  the  Cartwright 
lectures  which  I  gave  before  the  College  of  Physicians  and 
Surgeons  in  New  York  in  1898: '  — 

In  1875,  Tschertneisky-Barischewsky  cut  out  a  piece  of  the 
intestines  in  thirty-five  dogs,  with  twenty-nine  recoveries  —  a 
startling  result  when  compared  with  the  former  fatality  of  such 
operations.  This  was  the  starting  point  in  the  new  gastro-intes* 
tinal  surgery.  The  next  year  Gussenbauer  and  Winiwarter  cut 
out  a  piece  of  the  stomach  in  only  seven  dogs.  We  scarcely  can 
appreciate  at  this  day,  though  these  experiments  are  so  recent, 
how  many  new  questions  had  to  be  answered.  After  their  first 
unsuccessful  experiment  they  naively  remark  that  certain  facts 
were  established  by  the  experiment,  among  them,  "that  the  sur- 
faces of  the  stomach  have  a  real  tendency  toward  union  by  first 
intention,  .  .  .  just  as  do  wounds  of  the  skin."  (!)  Whether  this 
would  be  correct  of  man  as  well  as  of  animals  they  admitted  was 
as  yet  uncertain.  Another  point  settled  by  the  experiment  was 
"that  there  was  no  digestion  of  the  mucous  membrane  in  the 
neighborhood  of  the  wound."  Their  second  experiment  was  fol- 
lowed by  recovery,  and  showed  not  only  that  such  an  operation 
could  be  successfully  done,  but  that  the  narrowing  caused  by  the 
scar  did  not  interfere  with  the  functions  of  the  stomach,  either  as 
to  its  movement  or  its  secretion  of  the  digestive  juices,  and  that 
the  removal  of  the  pylorus  (the  opening  from  the  stomach  into 
the  intestine)  was  not  followed  either  by  the  too  early  escape  of 
the  food  into  the  intestines,  or  by  the  reflux  of  the  intestinal  con- 
tents into  the  stomach.  The  dog  was  killed  five  months  later  and 
the  post-mortem  showed  no  contraction,  by  reason  of  the  scar,  and 
no  digestion  of  the  edges,  and  his  perfect  health  after  the  opera- 
tion showed  that  the  movements  of  the  stomach  and  its  digestive 

^  In  quoting  this  I  have  popularized  some  of  the  medical  terms  there 
used. 


90  ANIMAL  EXPERIMENTATION 

functions  had  not  been  interfered  with.  Then,  again,  the  ques- 
tion whether  catgut  or  other  suture  material  was  the  best,  and 
what  kind  of  a  knot  and  what  kind  of  a  suture  would  best  answer 
were  subjects  of  debate. 

Our  antivivisection  friends,  who  so  often  declare  that  experi- 
ments upon  animals  have  never  contributed  anything  to  the 
progress  of  surgical  science,  may  well  be  challenged  to  account 
for  the  remarkable  progress  in  the  surgery  of  the  stomach  which 
immediately  followed  these  fruitful  experiments.  The  dogs  that 
died  did  not  die  in  vain.  They  showed  the  correct  methods  and 
indicated  errors  in  technic,  and  directly  led  up  to  the  modern  sur- 
gery of  the  stomach  and  the  intestine  in  man,  as  follows :  In  the 
very  same  year,  1876,  Hueter  cut  out  a  part  of  the  bowel,  though 
without  success.  In  1877  Czerny  for  the  first  time  sewed  up  the 
intestine,  and  dropped  it  into  the  abdominal  cavity,  with  recov- 
ery; followed  almost  immediately  by  Billroth,  who  did  the  first 
successful  suture  of  the  stomach  and  total  removal  of  a  portion 
of  the  bowel.  In  1878  Forelli  operated  for  a  wound  of  the  stom- 
ach, and  in  1879  Cavazzani  removed  a  portion  of  the  stomach  for 
tumor.  In  the  same  year  Pean  did  the  first  removal  of  the  py- 
lorus. In  1880  Rydygier  did  the  second,  and  in  1881  Billroth  did 
the  third  and  first  successful  one,  without  a  knowledge  of  the 
preceding  operations. 

Then  followed  various  operations  on  the  stomach  to 
which  I  will  allude  later,  and  finally  the  successful  removal 
of  the  entire  stomach.  It  is  quite  impossible  to  give  the  de- 
tails of  all  the  various  operations  now  done  on  the  stomach 
and  indicate  minutely  the  part  that  vivisection  has  had  in 
developing  this  extraordinarily  successful  branch  of  modern 
surgery.  SufiBce  it  to  say  that  among  them  are  the  follow- 
ing, all  of  which  owe  more  to  vivisection  experiments  than 
to  any  other  single  agency:  — 

In  cancer  of  the  esophagus  or  in  the  constriction  of  the 
esophagus,  which  so  often  follows  the  accidental  or  inten- 
tional swallowing  of  lye  or  acids,  etc.,  so  that  no  food  can 
get  into  the  stomach,  we  now  open  the  abdomen,  open  the 
stomach,  introduce  a  tube  or  construct  a  passageway  into 
the  stomach,  and  feed  the  patient  through  this  outside 
esophagus,  as  it  were.  In  case  the  narrowing  of  the  esoph- 


AND  MEDICAL  PROGRESS  91 

agus  is  not  from  cancer  the  patient  can  live  his  natural  span 
of  life.  In  case  of  cancer  his  remaining  days  are  rendered 
relatively  comfortable,  since  the  operation  prevents  his 
starving  to  death.  When  we  have  cancer  at  the  opposite 
end  of  the  stomach  (the  pylorus),  so  that  the  food,  though 
it  can  be  swallowed,  cannot  get  out  of  the  stomach,  one  of 
two  courses  is  followed,  both  of  which  have  been  carefully 
studied  in  the  lower  animals  and  then  adapted  to  man. 
First,  the  portion  of  the  stomach  and  bowel  involved  in  the 
cancer  is  cut  out  and  the  bowel  united  to  the  stomach  di- 
rectly, or,  in  other  cases,  an  opening  is  made  in  the  stom- 
ach and  one  in  the  bowel  lower  down,  and  the  two  openings 
are  sewed  together,  thus  allowing  the  food  to  pass  from  the 
stomach  directly  into  the  bowel  beyond  the  cancer.  The 
mere  question  of  how  the  stomach  and  bowel  can  be  most 
successfully  united  in  these  cases,  particularly  the  best 
method  to  prevent  fatal  leakage,  has  required  very  many 
series  of  experiments,  especially  in  this  country,  by  Senn, 
Abbe,  Brockaw,  Ashton,  Murphy,  and  others.  As  a  result 
of  their  labors  sometimes  we  have  learned  how  not  to  do 
the  operation  because  of  unexpected  difficulties;  sometimes 
how  to  better  our  procedure,  until  now  we  are  in  possession 
of  satisfactory  methods,  as  has  been  proved  by  the  success- 
ful operations  on  man  many  times  over.  Even  the  sewing 
together  of  the  stomach  and  bowel  alone  had  been  done 
up  to  1898  in  550  cases  which  have  been  published.  I  have 
no  doubt  that  since  then  this  number  has  almost  been 
doubled.  The  mortality  of  this  operation  from  1881  to 
1885  was  65.71  per  cent;  from  1886-90,  the  mortality  had 
fallen  to  46.47  per  cent;  from  1891  it  had  again  fallen  to 
33.91  per  cent,  and  recently  in  twenty-seven  cases  an 
Italian  surgeon  (Carle)  has  had  a  mortality  of  only  7.4  per 
cent. 

Moreover,  the  experiments  on  animals,  having  shown 
how  safe  various  operations  are,  have  emboldened  us  to 
enlarge  the  sphere  of  our  operations  and  do  others  that 


92  ANIMAL  EXPERIMENTATION 

were  before  not  dreamed  of — a  good  instance  of  the  partly 
indirect  good  results  from  vivisection. 

A  brief  enumeration  of  some  of  the  various  operations 
done  upon  the  stomach,  together  with  their  mortality,  is 
as  follows :  — 

(1)  Where  the  stomach  is  bound  down  by  adhesions 
(which  often  produce  the  most  serious  digestive  disturb- 
ances, destroying  comfort  and  even  threatening  life),  we 
now  open  the  abdomen,  cut  or  tear  the  adhesions,  and  prac- 
tically all  of  the  patients  recover. 

(2)  Where  there  are  foreign  bodies  in  the  stomach  (or  in 
some  cases  foreign  bodies  that  have  stuck  in  the  esophagus 
low  down,  near  the  stomach),  we  open  the  stomach,  remove 
the  foreign  body  (inserting,  if  need  be,  the  arm  to  reach 
it  in  the  esophagus),  sew  up  the  stomach  and  the  abdom- 
inal wall,  and  the  patients  generally  recover.  In  some  cases 
as  many  as  192  staples,  buttons,  screws,  horseshoe  nails, 
etc.,  weighing  over  a  pound  and  a  half,  have  been  re- 
moved, and  the  patients  have  recovered. 

(3)  Where  the  esophagus  has  been  narrowed  by  the  swal- 
lowing of  lye,  etc.,  instead  of  making  a  permanent  opening 
in  the  stomach  (as  before  described),  sometimes  by  having 
the  patient  swallow  a  perforated  shot  which  will  carry  a 
string  down  into  the  stomach,  we  can  open  the  stomach 
temporarily,  seize  and  draw  out  the  shot,  attach  a  conical 
dilator  to  the  string,  and,  after  having  dilated  the  con- 
striction of  the  esophagus,  remove  the  string,  sew  up  the 
stomach  and  the  abdominal  wall  and  cure  the  patient 
permanently. 

(4)  We  now  open  the  stomach  purely  to  explore  it  and 
find  out  whether  or  not  there  is  serious  disease.  This  has 
enabled  us  in  many  cases  to  relieve  illness  which  otherwise 
was  incurable.  Nearly  all  of  these  patients  recover  from 
the  operation. 

(5)  The  permanent  opening  in  the  stomach  through 
which  we  can  feed  a  patient  I  have  already  described.   It 


AND  MEDICAL  PROGRESS  93 

was  first  proposed  in  1837.  It  was  first  done  in  1849. 
From  then  until  1875  twenty-eight  cases  were  operated  on, 
with  twenty-eight  deaths !  It  seemed  almost  as  though  the 
operation  must  be  abandoned  when,  in  1875,  the  first  oper- 
ative recovery  occurred.  From  then  until  1884  in  163  cases 
there  were  133  deaths  —  a  mortality  of  81.66  per  cent.  At 
the  present  time  the  mortality  is  only  about  twenty-five 
per  cent  in  cases  of  cancer,  and  in  the  non-malignant  cases 
not  over  ten  per  cent. 

(6)  As  I  have  indicated,  in  certain  conditions  we  make 
an  opening  in  the  stomach  and  another  in  the  bowel  and 
sew  the  two  openings  together.  In  some  cases  of  ulcer  of 
the  stomach,  which  cannot  be  cured  by  medical  means,  this 
gives  wonderful  results,  both  as  to  comfort  and  cure.  The 
operation  was  first  done  in  1881,  with  a  mortality  decreas- 
ing from  65.71  to  33.91  per  cent  in  general,  and  in  the  sta- 
tistics of  single  surgeons  to  only  7.4  per  cent. 

(7)  The  first  removal  of  the  pylorus  with  union  of  the 
bowel  and  stomach  was  done  in  1879.  The  mortality  was 
very  great,  and  is  still  large,  ranging  from  27.2  per  cent  in 
simple  cases  to  72.7  per  cent  when  there  are  extensive  ad- 
hesions. 

(8)  When  the  pylorus  is  simply  narrowed,  but  is  not  the 
seat  of  cancer,  we  make  an  incision  in  its  long  axis,  seize  the 
edges  of  the  incision  at  the  middle,  draw  them  out  at  right 
angles  to  the  line  of  the  incision,  and  by  sewing  them  in 
this  position  we  widen  the  opening  of  the  pylorus.  This 
was  first  done  in  1886.  Up  to  1894  the  mortality  was  20.7 
per  cent.  Recently  Carle  has  reported  fourteen  cases,  with 
a  mortality  of  only  seven  per  cent. 

(9)  In  not  a  few  disorders  the  stomach  is  dilated  to 
nearly  two  or  three  times  its  normal  size.  In  these  cases  we 
now  take  a  "tuck"  in  it,  as  was  first  done  in  1891.  Up  to 
three  years  ago  fifteen  such  operations  had  been  done,  with 
only  one  death. 

(10)  When  the  stomach,  instead  of  being  dilated,  is  dis- 


94  ANIMAL  EXPERIMENTATION 

placed,  we  sew  it  fast,  and  practically  in  all  cases  recovery 
follows. 

(11)  Sometimes  the  stomach  is  divided  into  two  parts, 
like  an  "hour-glass**  or  a  dumb-bell  with  a  very  short 
handle.  The  first  operation  for  relieving  this  condition  was 
done  in  1893  by  making  an  opening  in  each  half  of  the 
stomach  and  sewing  the  two  openings  together.  Up  to 
this  year  over  forty  operations  have  been  done  for  this 
condition,  with  only  nine  deaths. 

(12)  Tumors  of  the  stomach  other  than  cancer  are  rare, 
but  since  1887  at  least  seven  cases  of  tumor  have  been  cut 
out,  of  which  six  have  recovered. 

(13)  Partial  removal  of  the  stomach  finally  led  to  its 
complete  removal,  of  which  over  a  dozen  instances  have 
been  reported,  with  a  recovery  of  somewhat  more  than  half. 
Nearly  all,  however,  have  died  from  recurrence. 

Some  of  the  above  operations  are  not  the  direct  result  of 
experiment  upon  animals  (as,  for  instance,  the  taking  of  a 
tuck  in  the  stomach) ;  but  they  are  the  indirect  result,  first, 
through  the  antiseptic  method,  which  itself  is  the  child  of 
vivisection,  and,  secondly,  because  through  our  experience 
in  other  operations  we  have  been  led  to  perform  totally  new 
ones.  It  is  the  same  in  other  sciences.  If  we  were  still  de- 
pendent upon  the  old  "air-pump"  worked  by  hand,  we 
should  have  no  lighting  by  the  incandescent  bulb  of  to- 
day, for  this  is  dependent  upon  a  cheap  method  of  making 
an  almost  complete  vacuum.  This  is  a  wholly  unexpected 
and  indirect  result  of  improvement  in  air  pumps  as  one  of 
the  chief  factors  of  progress. 

The  Intestines 

Very  much  the  same  story  can  be  told  of  the  surgery  of 
the  bowel.  Indeed,  the  surgery  of  the  stomach  involves 
largely  that  of  the  bowel.  I  need,  therefore,  only  recall  a 
very  few  points.  When  a  tumor  or  cancer  exists  in  the 
bowel,  of  course,  in  a  little  while  it  obstructs  the  passage  of 


AND  MEDICAL  PROGRESS  95 

the  intestinal  contents;  and  if  this  obstruction  becomes 
complete  and  is  not  quickly  removed,  the  patient  must 
necessarily  die.  As  a  result  of  many  experiments  upon  ani- 
mals (more  especially  by  Senn,  Parkes,  and  other  American 
surgeons)  we  now  know  how  to  deal  with  this  condition. 
First,  if  the  tumor  or  cancer  can  be  removed,  it  is  cut  out 
entirely,  and  the  two  ends  of  the  bowel  are  united.  Our 
present  successful  means  of  uniting  them  are  a  result  of 
most  laborious  researches  by  experimentation  upon  ani- 
mals to  discover  the  best  method  of  doing  this  otherwise 
perilous  operation.  The  slightest  leakage  of  intestinal  con- 
tents produces  a  fatal  peritonitis.  Where  the  cancer  can- 
not be  removed,  in  order  to  prolong  the  patient's  life  and 
lessen  his  terrible  pains,  we  make  an  opening  above  the  ob- 
struction and  another  one  below  and  sew  the  two  openings 
together.  Here  again  many  experiments  were  needed  to  de- 
termine whether  an  animal  could  live  with  the  intestinal 
contents  thus  "side-tracked,"  and  if  life  could  be  main- 
tained, what  was  the  best  method  of  doing  the  operation. 
In  gunshot  wounds  of  the  intestines,  which  formerly 
were  among  the  most  fatal  of  all  accidents,  we  now  can 
rescue  a  very  large  percentage  of  the  patients.  During  the 
Civil  War  practically  almost  every  case  of  perforation  of 
the  intestine  by  gunshot  died.  To  see  whether  something 
could  not  be  done  to  remedy  this  frightful  mortality,  Gross 
many  years  ago  performed  some  experiments  to  determine 
the  best  treatment  of  such  wounds.  Later  Parkes  etherized 
a  number  of  dogs,  shot  them,  opened  the  abdomen  and 
treated  the  wounds  in  various  ways;  and  in  consequence  of 
this  and  other  series  of  experiments,  at  the  present  time 
many  instances  of  recovery  have  been  reported  in  which 
multiple  wounds  even  to  the  number  of  seventeen  have 
been  found  closed  by  methods  determined  by  vivisection 
to  be  the  best,  and  the  patients  have  recovered.  To  reach 
this  result  it  had  to  be  determined  by  accurate  observa- 
tion on  animals  what  was  the  best  method  of  closing  such 


96  ANIMAL  EXPERIMENTATION 

wounds;  what  material  is  the  best  for  use  as  a  thread;  under 
what  conditions  it  would  be  needful,  instead  of  closing  the 
wound,  to  cut  out  the  injured  portion  of  the  bowel  and 
unite  the  two  ends;  how  long  after  perforation  occurred  was 
the  best  time  to  operate,  and  many  other  such  questions 
too  technical  to  mention  here. 

In  typhoid  fever  and  in  ulcer  of  the  stomach  also  some- 
times a  perforation  similar  to  the  hole  made  by  a  bullet 
occurs,  and  the  contents  of  the  intestines  or  of  the  stom- 
ach are  poured  out  into  the  abdominal  cavity.  Of  course, 
every  one  knows  that  if  this  went  on  for  a  brief  time  death 
would  necessarily  follow.  In  the  lower  animals  we  cannot 
produce  exactly  the  conditions  following  gastric  ulcer  and 
typhoid  fever;  but,  in  consequence  of  the  knowledge  ac- 
quired by  experimenting  upon  gunshot  and  incised  wounds 
of  the  stomach  and  bowel  in  the  lower  animals,  in  1884, 
we  finally  woke  up  to  the  fact  that  a  perforation  after  such 
an  ulcer,  either  in  the  stomach  or  in  the  bowel  from  typhoid 
fever,  ought  to  be  closed.  In  156  cases  of  such  perforation 
of  the  stomach  operation  has  been  done,  and  the  recoveries 
have  been  46.80  per  cent.  But  in  the  last  54  of  these  oper- 
ations done  from  1896  to  1898  the  percentage  of  recoveries 
had  risen  to  64.82  per  cent.  In  158  such  operations  done  for 
perforation  of  the  bowel  in  typhoid  fever  collected  in  1898 
the  recovery  rate  was  23.41  per  cent.  Since  then  it  has 
risen  to  over  one  in  three,  and  ultimately,  I  believe,  one 
half  of  such  patients  will  be  saved.  It  must  be  remembered 
that  in  such  perforations  of  the  stomach  and  bowel  every 
patient  would  die  were  no  operation  done.  To  save  one 
half  or  even  one  third  is  a  surgical  triumph. 

I  have  several  times  alluded  to  cutting  out  a  portion  of 
the  bowel  and  uniting  the  two  ends.  This  involves  a  num- 
ber of  problems  which  ought  not,  and,  in  fact,  cannot,  be 
studied  in  man  because  of  the  fact  that  it  is  wholly  inad- 
missible to  test  such  operations  (which  always  involve  life) 
on  man  when  they  can  be  tested  accurately  and  more 


AND  MEDICAL  PROGRESS  07 

quickly  by  experiments  on  animals  without  involving 
human  life. 

I  have  stated  that  by  many  experiments  on  animals  we 
have  now  reached  a  satisfactory  solution  of  the  problem 
how  the  two  ends  of  the  bowel  are  best  sewed  together. 
But  one  other  question  was  still  unanswered  —  how  much 
of  the  bowel  could  be  removed  and  yet  life  be  preserved. 
A  similar  question,  we  have  seen,  has  been  answered  in 
respect  to  how  much  of  the  liver  could  be  removed  by 
Ponfick's  experiments.  How  much  of  the  bowel  could  be 
removed  was  a  most  important  question.  We  would  all  pre- 
sume that  a  few  inches,  possibly  even  a  foot  or  two,  might 
be  removed  without  danger;  but  when  we  remove  a  larger 
portion  we  cut  down  the  digesting  and  absorbing  surface 
to  such  an  extent  that  it  is  a  question  whether  the  patient 
can  still  live.  This  has  been  determined  upon  animals,  and 
then,  as  occasion  required  us  to  decide  the  question,  in  man. 
As  a  result  of  the  knowledge  derived  from  animal  experi- 
mentation I  saw  four  years  ago  in  Montreal  a  man  from 
whom  Shepherd  had  removed  eight  feet  (over  one  third  of 
the  entire  length  of  the  bowel)  which  was  involved  in  a 
large  tumor;  and  yet  the  patient  was  in  capital  health  a 
long  time  after  the  operation. 

Hydrophobia 

The  search  for  the  germ  of  this  dreadful  disease  has  as 
yet  been  fruitless;  but  happily  the  search  for  the  means  of 
prevention  has  been  crowned  with  success.  Before  Pas- 
teur, of  every  hundred  persons  bitten  about  fifteen  con- 
tracted hydrophobia  and  every  one  died.  Of  those  bitten 
on  the  head  and  face  at  least  eighty  per  cent  contracted 
hydrophobia  and  again  every  one  died.  The  Pasteur 
treatment,  which  is  entirely  the  result  of  animal  experi- 
mentation, by  preventing  its  occurrence,  has  reduced  the 
mortality  to  less  than  one  'per  cent;  and  yet  the  establish- 
ment of  Pasteur  Institutes  for  the  benefit  of  the  human 


98  ANIMAL  EXPERIMENTATION 

race  has  been  resisted  most  strenuously  by  those  opposed 
to  vivisection.^ 

Transplantation  of  Bone 

In  1867,  Oilier,  a  celebrated  French  surgeon,  who  re- 
cently died,  by  experiments  on  animals  showed  that  the 
membrane  which  covers  the  bones  (the  periosteum)  could 
be  peeled  off  a  bone  and  transplanted  to  a  distance  into 
the  tissues  of  the  same  animal,  or  even  of  another  animal, 
and  that  it  would  there  live  and  produce  new  bone.  These 
experiments,  very  crudely  described  in  these  few  words, 
have  been  extraordinarily  fruitful  in  several  directions. 

First,  in  certain  cases  it  is  necessary  to  remove  diseased 
or  dead  bone.  These  experiments  showed  us  that  if  in  re- 
moving the  bone  the  periosteum  was  carefully  guarded  and 
left  behind  it  would  reproduce  the  bone.  In  some  cases  in 
which  the  lower  jawbone  has  died  as  a  result  of  phosphorus 
poison  in  the  employees  of  phosphorus  match  factories,  the 
dead  bone  has  been  removed,  but  the  periosteum  has  been 
preserved  and  a  new  jawbone  has  been  reproduced.  An- 
other result  has  been  that,  instead  of  amputating,  for  ex- 
ample, an  arm  when  the  elbow  is  diseased,  we  can  remove 
the  bone  and  by  preserving  the  periosteum  can  preserve  a 
more  or  less  useful  joint. 

In  other  cases  a  certain  area  of  bone,  as,  for  instance,  in 
the  skull,  is  chiseled  loose  or  otherwise  separated  from  the 
surrounding  bone  excepting  for  an  inch  or  two  at  the  por- 
tion where  the  chief  blood  supply  enters  the  flap.  The  bone 
is  then  forcibly  broken  at  this  unchiseled  portion  and 
turned  back,  the  periosteum  and  scalp  acting  as  a  hinge. 
When  the  tumor  has  been  removed,  the  abscess  opened,  or 
other  needful  operation  done,  the  trap  door  is  simply  closed 
by  replacing  the  flap  of  bone,  the  scalp  sewed  in  place  and 

*  In  spite  of  the  wearisome  reiteration  of  Dr.  Charles  W.  Dulles  that 
there  is  no  such  disease  as  hydrophobia,  the  actual  germ  of  the  disease  has 
just  been  discovered  at  the  Rockefeller  Institute.    (1914.) 


AND  MEDICAL  PROGRESS  99 

the  integrity  of  the  skull  is  restored.  One  can  see  that  this 
is  an  immense  advantage  over  having  a  great  hole  left  in 
one's  skull. 

In  some  cases,  in  which,  in  consequence  of  accident  or 
abscess,  a  large  hole  already  exists  in  the  skull,  we  either 
chisel  off  bits  of  adjacent  bone  or  take  pieces  of  bone 
from  one  of  the  lower  animals  and  successfully  fill  this 
opening. 

Again,  in  certain  cases,  for  example,  in  which  the  jaw 
has  been  fractured,  a  bit  of  the  bone  has  been  chiseled  loose 
from  the  patient's  jaw  and  has  been  grafted  in  place  as  a 
bridge  between  the  two  fragments,  so  relieving  the  deform- 
ity or  remedying  an  otherwise  incurable  fracture. 

Again,  a  certain  small  number  of  children  are  born  with- 
out any  bone  at  the  back  of  the  spine  in  the  neck  or  the  loin 
(spina  bifida).  Through  this  opening  the  membranes  of 
the  spinal  cord  protrude  and  form  a  tumor  which,  if  un- 
treated, in  most  cases  proves  fatal.  We  now  operate  most 
successfully  on  many  of  these  cases,  and  in  suitable  cases 
either  chisel  loose  a  bit  of  adjacent  bone  and  transplant  it, 
so  as  to  close  the  opening,  or  in  other  cases  take  a  bit  of 
bone  from  one  of  the  lower  animals  to  fill  the  opening  and 
cure  the  patient. 

Again,  in  certain  cases  of  fracture  of  the  arm  bone  (hu- 
merus), the  nerve  going  to  the  muscles  on  the  back  of  the 
forearm,  which  winds  close  around  the  bone  on  a  spiral,  is 
torn  in  two;  these  muscles  are  paralyzed,  and  the  patient 
has  what  we  term  "wrist  drop,"  so  that  the  hand  is  useless. 
In  such  cases  the  knowledge  derived  from  two  different 
series  of  experiments  comes  to  our  aid  to  enable  us  to  rem- 
edy the  trouble.  First  we  expose  the  two  ends  of  the  broken 
nerve,  freshen  these  ends,  unite  them,  and  in  many  cases 
can  change  a  useless  hand  into  a  useful  one;  but  if  so  much 
of  the  nerve  has  been  destroyed  that  the  two  ends  cannot 
be  brought  together  we  now  deliberately  remove  an  inch 
or  two  of  the  arm  bone,  thus  shortening  the  arm  so  as  to 


100  ANIMAL  EXPERIMENTATION 

bring  the  two  ends  of  the  nerve  together,  unite  them,  wire 
the  two  ends  of  the  bone  together,  and  in  a  good  percentage 
of  cases  we  can  again  restore  the  hand  to  usefulness  after 
months  and  occasionally  even  after  years. 

A  still  more  remarkable  transplantation  of  the  bone  is 
accomplished  in  some  operations  on  the  skull.  In  some  cases 
it  is  necessary  to  remove  a  button  of  bone  which  may  be 
an  inch  and  a  half  or  two  inches  in  diameter  in  order  to  do 
an  operation  on  the  brain.  The  operation  which  has  neces- 
sitated this  removal  of  bone  may  require  an  hour  and  a  half 
or  two  hours.  If  we  want  to  replace  the  bone  so  as  not  to 
leave  an  opening  in  the  skull  through  which  the  brain  may 
easily  be  dangerously  injured,  we  put  the  button  of  bone 
in  a  basin  of  hot  salt  solution  or  weak  antiseptic  solution, 
and  by  keeping  it  at  a  proper  temperature,  at  the  end  of  the 
operation,  when  it  has  been  totally  detached  from  the  body 
for  so  long  a  time,  we  replace  it  and  its  vitality  is  not  lost. 

All  of  these  various  operations  (and  others  which  I  have 
not  time  to  describe)  done  on  bone,  to  the  immense  advan- 
tage of  our  patients,  are  the  direct  or  remote  results  of  the 
experiments  of  Oilier  and  others  on  the  transplantation  of 
periosteum  and  of  bone.  The  indirect  results  are  quite  as 
valuable  as  the  direct  results  of  such  experiments,  and 
sometimes  more  valuable. 

An  illustration  of  the  indirect  results  of  Ollier's  experi- 
ments is  shown  in  the  transplantation  of  the  skin.  One  of 
the  oldest  operations  in  surgery  is  the  making  of  a  new  nose. 
When  the  nose  had  been  lost  a  suitable  shaped  flap  was  cut 
on  the  forehead,  leaving  a  sufficient  uncut  base  for  a  proper 
blood  supply  so  that  the  flap  would  not  imdergo  gangrene. 
The  flap  was  then  turned  by  twisting  it  on  its  base  and  was 
sewed  in  place  where  the  nose  had  been.  The  experiments 
of  Oilier  and  his  successors  showed,  however,  that  perios- 
teum, and  even  so  dense  a  structure  as  bone,  could  be  en- 
tirely detached  from  the  body  for  a  long  time  and  yet  not 
lose  its  vitality.  Hence  we  now  transplant  bone  as  well  as 


AND  MEDICAL  PROGRESS  101 

skin  to  make  firm  instead  of  flabby  noses.  This  has  led  us 
of  late  years  to  apply  the  same  procedures  to  the  skin,  and 
enables  us  now  to  do  far  more  extensive  and  more  successful 
operations  than  would  otherwise  have  been  possible.  The 
first  method  tried  in  man  was  that  of  Reverdin,  of  Geneva. 
He  cut  little  bits  of  skin  only  as  big  as  a  pin's  head  from  the 
arm  or  the  thigh,  not  quite  skin  deep,  and  planted  them  on 
any  raw  surface  which  did  not  heal  readily.  These  grafts 
under  proper  treatment  adhere  and  form  new  centers  from 
which  healing  of  the  wound  takes  place.  Emboldened  by 
this,  Krause  and  other  surgeons  have  taken  very  large 
pieces  of  skin,  including  often  the  whole  thickness  of  the 
skin,  detached  them  entirely,  and  transplanted  them.  For 
example,  in  some  cases  of  extensive  cancer  in  which  a  very 
large  portion  of  skin  must  be  removed,  now,  while  the  pa- 
tient is  under  the  influence  of  the  anesthetic,  we  take  strips 
of  skin  an  inch  wide  and  several  inches  long  from  the  thigh 
of  the  patient  during  the  operation,  or,  in  other  cases, 
from  another  person  who  is  willing  to  give  up  a  portion  of 
his  skin.  These  pieces  are  immediately  placed  on  the  raw 
place  left  by  the  removal  of  the  cancer,  and  as  they  do  not 
lose  their  vitality  but  grow  fast  to  the  tissues  under  them, 
the  wound  is  healed  almost  immediately,  instead  of  taking 
a  long  time  for  the  slow  formation  of  a  scar. 

One  of  the  most  diflScult  of  all  wounds  to  heal  is  an  ex- 
tensive burn,  such  as  is  produced  by  the  clothing  catching 
fire.  In  these  cases  large  surfaces  of  the  skin  on  the  chest 
or  the  abdomen  slough  off,  resulting  in  great  ulcers.  These 
sometimes  take  months,  sometimes  years  to  heal,  and  in 
not  a  few  cases  never  heal,  no  matter  what  is  done.  Now, 
as  a  result  of  our  experience,  first  with  the  periosteum  and 
bone  and  then  with  small  bits  and  then  larger  bits  of  skin, 
we  transplant  strips  of  skin  as  just  described,  and  such 
wounds  heal  in  a  very  short  time.  One  sees  in  the  news- 
papers every  now  and  then  accounts  of  some  woman  whose 
long  hair  has  been  caught  in  machinery  and  almost  all  of 


102  ANIMAL  EXPERIMENTATION 

the  scalp  torn  away.   These  wounds  are  healed  by  trans- 
planting skin  in  a  similar  manner. 

The  Blood 

We  are  at  present  only  just  beginning  to  appreciate  how 
much  we  can  learn  from  examination  of  the  blood,  espe- 
cially by  new  methods  lately  introduced.  Almost  every 
intelligent  person  knows  that  the  blood  consists,  roughly 
speaking,  of  a  fluid  in  which  float  small  circular  disks,  about 
one  three-thousandth  part  of  an  inch  in  diameter,  called  the 
red  blood  cells.  In  addition  to  these  there  is  in  the  blood  an- 
other kind  of  cell  called  the  white  blood  cell.  The  red  blood 
cells  are  made  up  chiefly  of  a  substance  called  hemoglobin, 
which  gives  the  color  to  the  blood.  Some  of  the  investiga- 
tions, which  are  really  only  at  present  at  the  beginning  of 
their  usefulness,  are  as  follows.  They  are  good  illustrations 
of  how  inductive  science  begins  by  ascertaining  facts.  If 
they  are  valueless  they  are  disregarded;  if  of  value  they 
are  studied  still  further.  It  is  not  unlikely  that  the  blood 
may  soon  be  one  of  the  most  fruitful  sources  of  the  knowl- 
edge by  which  surgery  may  profit  greatly.  ^ 

First,  the  number  of  white  blood  cells.  It  is  found  that 
in  case  inflammation  results  in  an  abscess  the  number  of 
white  blood  cells  is  increased  several  times.  Ordinarily  in 
a  little  cube  of  blood  one  millimeter  (the  twenty-fifth  part 
of  an  inch)  on  each  of  its  sides  the  number  of  red  blood  cells 
is  about  four  to  five  millions,  and  the  number  of  white  blood 
cells  is  eight  thousand  to  ten  thousand. 

If  one  has  an  abscess,  the  white  blood  cells  as  a  rule 
will  rise  to  fifteen  thousand,  twenty  thousand,  twenty-five 
thousand,  or  more  to  the  cubic  millimeter  —  a  condition 
that  we  know  scientifically  as  "leucocytosis."  In  certain 
cases  when  it  is  a  question  whether  an  abscess  exists  (as, 
for  instance,  in  the  brain,  in  the  liver,  and  other  parts  of 

1  Immense  progress  in  the  study  of  the  blood  has  been  made  in  the 
thirteen  years  since  this  was  written.    (1914.) 


AND  MEDICAL  PROGRESS  103 

the  body  in  which  the  diagnosis  is  very  difficult  to  make), 
if  the  leucocytosis  or  its  absence  will  show  us  absolutely 
that  there  is  or  is  not  an  abscess  present,  it  would  be  of  the 
greatest  help. 

Again,  in  typhoid  fever  the  pain  and  tenderness  exist  just 
above  the  right  groin.  In  appendicitis  the  pain  and  tender- 
ness exist  in  the  same  region,  and  in  not  a  few  cases  it  is  ex- 
tremely difficult  to  distinguish  between  these  two  diseases. 
Especially  is  this  true  at  the  beginning  of  such  an  illness, 
just  when  it  is  most  important  to  make  the  right  diagnosis 
and  institute  the  correct  treatment.  If  the  presence  of  leu- 
cocytosis will  show  us  distinctly  that  it  is  appendicitis,  and 
the  absence  of  leucocytosis  that  it  is  typhoid  fever,  an  im- 
mense gain  in  accuracy  of  diagnosis,  and,  therefore,  of  the 
proper  treatment,  will  result.  To  open  the  abdomen,  if  it  is 
typhoid  fever  (without  perforation),  would  be  a  dreadful 
mistake;  not  to  open  it,  if  it  is  appendicitis,  would  be,  as  a 
rule,  equally  wrong  treatment.  If  the  leucocytosis  is  a  sure 
guide  we  cannot  learn  it  too  quickly.  It  seems  to  me  very 
reasonable,  therefore,  that  experiments  should  be  made  in 
the  lower  animals  by  producing  abscesses  and  determining 
whether  under  many  varying  conditions  leucocytosis  is 
always  present  when  there  is  an  abscess  and  always  absent 
when  there  is  no  abscess.^ 

Second,  Hemoglobin,  The  hemoglobin,  which  makes  up 
the  bulk  of  the  red  blood  cells,  is  the  means  by  which  oxy- 
gen is  carried  to  all  parts  of  the  tissues.  Whenever  an  anes- 
thetic, such  as  ether  or  chloroform,  is  given,  the  amount  of 
hemoglobin  is  distinctly  diminished,  and  by  this  means  the 
oxygenation  of  the  blood  is  hindered.  In  certain  conditions 
of  the  system  the  percentage  of  hemoglobin  is  diminished 
to  sixty,  fifty  or  even  as  low  as  twenty-five  per  cent  of  the 
normal.  If  an  anesthetic  is  given  to  a  person  with  an  al- 
ready diminished  percentage  of  hemoglobin  this  percentage 
is  still  further  diminished,  and  the  oxygenation  of  the  blood 

*  This  is  now  a  constant  and  valuable  means  of  diagnosis.  (1914.)  , 


104  ANIMAL  EXPERIMENTATION 

still  further  hindered.  If,  then,  the  percentage  of  hemo- 
globin is  very  small  before  an  operation,  the  danger  of  giv- 
ing an  anesthetic  is  very  marked;  if  the  hemoglobin  is  as 
low  as  thirty  per  cent,  it  is  very  likely  that  the  patient  may 
die  upon  the  table  irrespective  of  the  operation,  simply  be- 
cause the  anesthetic  reduces  the  hemoglobin  to  such  a  point 
that  the  blood  does  not  absorb  enough  oxygen  to  carry  on 
life.  Some  authorities  have  stated  that  we  ought  never  to 
give  ether  or  chloroform  to  a  patient  whose  hemoglobin  is 
below  fifty  per  cent.  Others  have  placed  the  limit  as  low  as 
thirty  per  cent.  Surely  this  subject,  which  is  very  recent 
and  about  which  we  know  up  to  this  time  very  little,  ought 
to  be  investigated  with  the  greatest  care  in  animals  rather 
than  to  decide  the  question  by  sacrificing  life  by  venturing 
to  give  an  anesthetic  to  patients  whose  hemoglobin  is  at  so 
low  a  point  as  to  be  inconsistent  with  safety. 

Other  recent  researches  are  those  on  the  temperature  at 
which  the  blood  freezes  and  the  lapse  of  time  after  the 
blood  is  drawn  from  the  body  before  it  coagulates  —  that 
is,  clots.  A  small  portion  of  blood  drawn  by  a  prick  of  the 
finger  enables  us  to  determine  these  four  conditions  — 
i.e.,  (1)  the  presence  or  absence  and  degree  of  leucocytosis; 
(2)  the  percentage  of  hemoglobin;  (3)  the  freezing  tempera- 
ture of  the  blood,  and  (4)  the  coagulation  time  of  the  blood. 
We  are  beginning  to  see  that  these  last  two  as  well  as  the 
first  two  will  probably  prove  of  the  greatest  value  in  refer- 
ence to  surgical  operations.  Hence  we  ought  to  learn  accur- 
ately and  quickly  all  the  facts  in  the  case  by  experiments 
upon  animals,  and  so  avoid  dangers  to  human  life  of  which 
until  lately  we  have  been  quite  ignorant. 

These  would  include  experiments  upon  animals  fasting, 
or  after  feeding;  after  being  bled;  after  surgical  operations 
have  been  done  upon  them;  after  an  anesthetic  is  given  to 
them;  when  the  anesthetic  is  administered  for  a  short  time, 
for  a  longer  time,  for  a  very  long  time,  or  for  a  time  long 
enough  to  kill  them,  in  order  to  determine  what  the  effect 


AND  MEDICAL  PROGRESS  105 

of  the  anesthetic  is  in  fatal  and  non-fatal  doses.  It  is  of  the 
utmost  importance  that  we  should  know  exactly  and  speed- 
ily the  result  of  all  these  conditions.  If  we  are  debarred 
from  learning  them  by  experiment  on  animals,  then  the  hu- 
man race  must  go  without  the  knowledge  we  seek,  saving 
as  it  is  revealed  to  us  from  time  to  time  by  studying  slowly 
and  inexactly  the  results  in  man.  With  certain  modifica- 
tions due  to  the  slight  differences  between  man  and  animals 
the  conclusions  drawn  from  experiments  on  animals  apply 
to  man. 

Let  me  give  one  instance  which  confronts  the  surgeon  not 
infrequently.  An  abdominal  section  is  occasionally  fol- 
lowed by  very  great  and,  it  may  be,  dangerous  and  alarm- 
ing depression.  One  of  the  most  difl&cult  things  to  deter- 
mine in  some  cases  is  whether  this  condition  is  due  to  the 
shock  of  the  operation  or  to  internal  hemorrhage.  This 
hemorrhage  differs  from  that  which  may  follow  an  ampu- 
tation or  removal  of  a  tumor  from  the  neck,  etc.,  by  the 
fact  that  it  is  concealed  within  the  abdomen,  and  its  exist- 
ence can  only  be  inferred.  If  the  patient  is  suffering  from 
shock,  stimulation,  heat,  quiet,  certain  drugs,  etc.,  will  be 
resorted  to  to  enable  him  to  recover.  If  it  is  due  to  internal 
hemorrhage,  we  must  instantly  reopen  the  abdomen  and 
tie  the  bleeding  vessel.  To  do  the  latter  operation  when 
the  patient  is  only  suffering  from  shock  might  prove  fatal; 
not  to  do  it,  if  hemorrhage  is  the  cause  of  the  depression,  is 
certainly  fatal.  No  one  not  a  surgeon  can  appreciate  the 
anxiety,  the  careful  weighing  of  evidence,  the  intense  long- 
ing for  some  positive  means  by  which  a  correct  diagnosis 
may  always  and  surely  be  made,  which  every  surgeon  feels 
in  such  an  emergency. 

It  is  possible  that  by  examining  into  the  presence  or  ab- 
sence of  leucocytosis,  by  determining  the  percentage  of  the 
hemoglobin,  or  possibly  even  the  coagulation  time  and 
the  freezing  temperature  of  the  blood  in  a  number  of  oper- 
ations in  human  beings,  we  might  be  able  positively  to  de- 


106  ANIMAL  EXPERIMENTATION 

termine  the  difference  between  shock  and  internal  hemor- 
rhage, but  only  after  making  many  blunders,  each  of  which 
would  cost  a  human  life:  every  life  so  lost  would  be  a 
needless  sacrifice  upon  the  altar  of  antivivisection.  In 
an  animal  we  can  open  a  blood  vessel  in  the  abdomen  and 
let  it  bleed  for  a  longer  or  shorter  time,  and  determine 
positively  the  leucocytosis,  the  hemoglobin,  etc.,  the  ani- 
mal meantime  suffering  nothing  because  it  would  be  un- 
der an  anesthetic.  Which  is  the  right,  which  the  kindest, 
which  the  most  humane  way  of  finding  out  the  truth? 
This  is  an  illustration  of  the  harmlessness  to  animals  of 
such  experiments  and  their  priceless  value  to  human 
beings. 

Experiments  to  enable  us  to  make  a  Reliable  and 
Speedy  Diagnosis 

In  some  cases  in  which  the  diagnosis  is  difficult,  or  may 
require  considerable  time,  experiment  upon  animals  aids 
us  greatly,  and  so  is  of  immense  value  to  man.  Thus  in 
supposed  anthrax,  or  wool-sorter's  disease,  a  most  danger- 
ous malady,  by  inoculating  a  guinea  pig  with  the  discharge 
the  diagnosis  can  be  cleared  up  quickly  and  proper  treat- 
ment instituted.  If  a  case  suspected  to  be  one  of  bubonic 
plague  arises,  the  diagnosis  can  be  established  within 
twenty-four  or  thirty-six  hours  by  a  similar  injection  into  a 
rat  or  a  guinea  pig,  the  apprehensions  of  a  community  (to 
say  nothing  of  the  patient  and  his  friends)  relieved  and  the 
greatest  damage  to  its  commerce  averted  by  discovering 
that  it  is  not  the  dreaded  pestilence,  or,  if  it  is  the  plague, 
by  showing  the  necessity  for  most  stringent  measures  to 
prevent  its  spreading.  I  do  not  think  any  community  will 
or  ought  to  allow  sympathy  with  the  unavoidable  suffer- 
ing of  a  few  rats  or  guinea  pigs  to  weigh  in  the  balance  for  a 
moment  against  the  safety  of  many  human  lives  and  the 
ruin  of  large  business  interests. 

An  amusing  instance  of  how  sentiment  gives  way  before 


AND  MEDICAL  PROGRESS  107 

affection  and  facts  occurred  not  long  since  in  England.  The 
brother  of  the  Duke  of  Newcastle  was  bitten  by  a  dog  sup- 
posed to  be  rabid.  The  Duke  was  president  of  the  Anti- 
vivisection  Society,  but  knowing  that  whether  the  dog  was 
rabid  or  not  (and,  therefore,  whether  his  brother  was  in 
danger  or  not)  could  only  be  settled  by  inoculation  experi- 
ments upon  animals,  he  took  the  dog  to  Horsley,  in  Lon- 
don, and  had  the  experiment  done.  He  was  promptly  de- 
posed from  his  presidency. 

By  similar  means  anthrax  and  actinomycosis  (or  lumpy- 
jaw,  which  spreads  to  man  as  well  as  to  herds)  among  cattle 
are  diagnosticated  and  eradicated;  glanders  in  horses  is 
recognized  and  stamped  out  and  tuberculosis  in  cows  is 
eradicated,  not  only  preventing  its  spread  to  healthy  cattle, 
but  through  the  milk  to  many  human  beings,  especially 
young  children,  whose  chief  diet  must  be  milk. 

By  similar  experiments  on  animals  the  causes  of  chicken 
cholera,  hog  cholera,  Texas  fever,  and  many  other  diseases 
of  cattle,  sheep,  horses,  hogs,  poultry,  and  other  animals 
have  been  discovered  and  the  means  of  prevention  or  of 
cure  demonstrated.  The  Reports  of  the  Bureau  of  Animal 
Industry  at  Washington  enter  into  these  in  detail.  Surely 
the  poor  animals  who  have  benefited  so  greatly  from  such 
experiments  should  pray  to  be  saved  from  their  friends  if 
these  beneficent  researches  are  to  be  prohibited.  ^ 

I  often  wonder  what  would  have  been  the  influence  on 
surgery  if  the  young  man  who  first  took  ether  in  the  Massa- 
chusetts General  Hospital  on  October  16,  1846,  had  died. 
Morton,  it  is  true,  had  experimented  on  some  dogs  first, 
but,  as  we  now  view  it,  very  inadequately.  Had  this  patient 
died,  would  not  the  use  of  ether  have  been  deferred  for 
years,  possibly  even  till  now,  and  meantime  the  human 
race  all  over  the  world  have  gone  on  suffering  the  horrible 
tortures  of  the  pre-anesthetic  days  and  all  our  modern 
progress  in  surgery  have  been  prevented.^  I  hardly  ever 
.  *  See  Pamphlet  No.  6  in  the  List  on  p.  xix. 


108  ANIMAL  EXPERIMENTATION 

look  on  my  patients  in  the  blessed  ether  sleep  without  be- 
ing impressed  with  the  confident  audacity  of  the  earlier 
operators  who  dared  to  induce  a  sleep  so  like  that  of  death 
when  they  must  often  have  asked  themselves  whether  the 
patient  would  ever  waken  or  whether  this  was  not  the  first 
stage  of  the  never-ending  sleep. 

If  the  sacrifice  of  the  lives  of  even  a  considerable  number 
of  animals  enables  us  to  reach  the  benevolent  purposes,  a 
few  of  which  I  have  described,  is  it  not  plainly  a  moral  duty 
to  perform  them  so  as  to  obtain  this  knowledge?  Is  it  not 
wrong  to  hinder  such  benevolent  researches?  Especially  is 
it  not  wrong  so  to  hinder  research  when,  in  the  vast  major- 
ity of  instances,  animals  suffer  little  or  nothing?  In  almost 
all  experiments  not  only  can  an  anesthetic  be  used,  but  in 
all  involving  difficult  and  delicate  operations  it  is  essential 
to  do  so;  for  it  is  impossible  to  do  such  an  operation  on  an 
animal  struggling  from  pain.  Not  only,  therefore,  does  sen- 
timent lead  the  vivisectionist  to  spare  the  animal  all  the 
suffering  that  is  possible,  but  scientific  accuracy  points  in 
the  same  direction.  A  very  few  experiments,  principally 
those  on  the  nervous  system  which  require  us  to  determine 
the  presence  or  absence  of  sensation,  cannot  be  done  with 
an  anesthetic;  but  these  experiments  are  few  and  far  be- 
tween. Some  experiments  also  (for  instance,  those  on  lock- 
jaw, to  which  I  have  already  alluded)  by  producing  the 
disease,  necessarily  make  the  animal  suffer;  but  if  by  the 
suffering  of  a  few  animals,  human  beings  suffering  from 
lockjaw  can  be  cured,  or,  still  better,  if  we  can  learn  the 
cause  of  the  disease  and  so  can  prevent  it  from  attacking 
human  beings,  is  it  not  worth  the  suffering?  The  infliction 
of  suffering  is  not  cruelty.  If  one  dear  to  us  meets  with  an 
accident  far  away  from  surgical  aid  and  we  spur  a  horse 
to  the  utmost  so  that  finally  it  drops  dead  in  our  frantic 
effort  to  bring  surgical  assistance,  I  am  sure  no  one  would 
accuse  us  of  cruelty,  although  we  had  inflicted  torture  upon 
the  horse.    So  this  infliction  of  pain  on  a  small  percentage 


AND  MEDICAL  PROGRESS  109 

of  animals  experimented  on  is  not  cruelty,  but  is  the  great- 
est kindness  to  other  animals  and  to  a  much  higher  animal 
—  man  himself. 

I  have  been  able  in  this  paper  to  select  only  a  few  illus- 
trations of  the  progress  that  surgery  has  made  by  experi- 
mentation on  animals.  Practically,  as  I  said  at  the  be- 
ginning, nearly  all  of  these  have  occurred  during  my  own 
professional  life,  and  I  speak,  therefore,  of  what  I  know. 
Although  I  myself  am  not  a  vivisectionist,  yet  I  could  not 
do  the  work  I  do  every  day  and  accomplish  results  I  obtain 
were  it  not  for  just  such  work,  of  which  I  take  advantage. 
In  view  of  these  facts,  therefore,  how  unwise  it  would  be 
to  restrict  and  still  more  to  abolish  such  life-giving  and  pain- 
saving  results  of  vivisection,  especially  when  the  animals 
themselves  benefit  from  these  experiments  fully  as  much  as 
man.  I  have  not  referred  to  any  of  the  older  experiments, 
such  as  those  remarkable  experiments  of  Jones  on  the  meth- 
ods of  tying  blood-vessels  in  the  early  part  of  the  last  cen- 
tury, nor  of  Sir  Charles  Bell's  experiments,  by  which  he 
determined  the  functions  of  the  two  different  roots  of  the 
nerves  just  as  they  emerge  from  the  spinal  cord,  nor  of  the 
circulation  of  the  blood  as  discovered  by  Harvey.  All  these 
are  fundamental;  and  without  the  knowledge  derived  from 
them  we  should  be  a  century  or  more  behind  where  we  are 
now.  I  have  preferred  rather  to  take  modern  instances 
with  which  I  am  personally  familiar  in  order  to  illustrate 
the  subject  which  I  have  been  asked  to  describe.  I  cannot 
believe  that  any  unprejudiced,  fair-minded  reader  will  not 
agree  with  me  that  such  humane  purposes  should  be  fos- 
tered and  not  hindered;  should  be  encouraged  and  not 
abolished. 


MISSTATEMENTS  OF  ANTIVIVISECTIONISTS 

CORRESPONDENCE    WITH   THE   AMERICAN   HUMANE 
ASSOCIATION  ^ 

LETTER  FROM   THE  PRESIDENT  OF   THE  AMERICAN 
HUMANE  ASSOCIATION  ^ 

Toledo,  Ohio,  Oct.  4,  1900. 

Professor  William  W.  Keen,  late  President  of  the  Amer- 
ican Medical  Association,  Jefferson  Medical  College, 
Philadelphia. 
Dear  Sir,  —  My  attention  has  just  been  called  to  a 
passage  in  the  published  "Report  of  the  Hearings"  before 
the  Senate  committee,  held  at  Washington  last  February, 
on  the  bill  for  regulation  of  vivisection.    In  this  volume 
the  following  conversation  between  Senator  Gallinger  and 
yourself  is  recorded :  — 

Senator  Gallinger  —  What  knowledge  have  you  of  the  ad- 
vances made  by  vivisectionists  that  have  led  them  to  progress 
from  the  brute  creation  to  the  human  creation  in  making  these 
so-called  vivisection  experiments? 

Dr.  Keen  —  I  presume  that  you  refer  to  a  pamphlet  issued  by 
the  American  Humane  Society.  I  have  only  to  say  in  reference 
to  it  that  there  were  a  number  of  experiments  which  I  would  ut- 
terly condemn.  Of  the  experiments  narrated  in  that  pamphlet, 
I  have  looked  up  every  one  that  I  could.  Only  two  are  alleged 
to  have  been  done  in  America.  Many  of  them  are  so  vague  and 
indefinite  that  I  could  not  look  them  up,  but  as  to  those  that  I 
could,  some  are  garbled  and  inaccurate;  not  all  of  them,  observe. 

Senator  Gallinger  —  Some  of  them.? 

Dr.  Keen  —  Some  of  them. 

1  Reprinted  by  permission  from  the  Journal  of  the  American  Medi- 
dal  Association  for  February  23,  1901. 

2  Printed  by  permission. 


MEDICAL  PROGRESS  111 

A  statement  of  this  character,  based  upon  such  author- 
ity, it  is  impossible  to  ignore.  Proceeding  from  one  less 
eminent  than  yourself  in  that  profession  which  you  repre- 
sent and  adorn  it  might  pass  without  notice,  but  coming 
from  you,  sir,  such  a  charge  must  be  investigated  and 
probed  to  the  fullest  extent.  Its  importance  is  evident,  and 
in  testing  its  accuracy  you  will  give  me,  I  trust,  every  assist- 
ance within  your  power. 

First :  Regarding  the  cases  of  experimentation  upon  hu- 
man beings  recorded  in  our  pamphlet,  "Human  Vivisec- 
tion," you  informed  the  Senate  committee  that  **many  of 
them  are  so  vague  and  indefinite  that  I  could  not  look  them  up" 
We  challenge  the  accuracy  of  that  statement,  and  ask  for 
proof.  Of  the  various  series  of  experiments  upon  human  be- 
ings, made  for  the  most  part  upon  women  and  children  in 
hospitals  and  infirmaries,  the  authorities  given  in  this 
pamphlet  are  as  follows :  — 

1.  Bulletin  of  the  Johns  Hopkins  Hospital,  July,  1897. 

2.  Boston  Medical  and  Surgical  Journal,  August  6  and  13, 
1896 ;  Philadelphia  Polyclinic,  September  5,  1896. 

3.  New  York  Medical  Record,  September  10,  1892. 

4.  British  Medical  Journal,  July  3,  1897;  New  England  Medi- 
cal Monthly,  March,  1898. 

5.  Medical  Press,  December  5, 1888;  British  Medical  Journal, 
August  29,  1891;  London  Times,  June  27,  1891;  and  other  jour- 
nals. 

6.  Medical  Brief,  June,  1899. 

7.  Ringer's  Therapeutics,  pp.  498,503;  585,  588,  590,  591,  The 
Lancet,  London,  November  3,  1893. 

8.  Newcastle  Daily  Chronicle,  September  21,  1888. 

9.  Medical  Press  and  Circular,  March  29,  1899;  The  Lancet, 
London,  May  6,  1899,  p.  1261. 

10.  Allg.  Wiener  med.  Zeitung,  nos.  50  and  51. 

11.  Deutsche  med.  Woch.,  nos.  46-48,  1894. 

12.  Ihid.,  February  19,  1891. 

13.  Lecture  before  Medical  Society  of  Stockholm,  Sweden, 
May  12,  1891. 

14.  British  Medical  Journal,  October  15,  1881;  Medical  Re- 
prints  for  May  16,  1893;  Nineteenth  Century,  December,  1895. 


112  ANIMAL  EXPERIMENTATION 

For  one  series  of  experiments  in  the  above  list,  those 
made  by  Dr.  Jansen  upon  children  of  the  "Foundlings' 
Home,"  —  with  the  "kind  permission"  of  the  head  physi- 
cian. Professor  Medin,  —  because,  as  he  said,  "calves  were 
so  expensive,"  it  appears  that  the  only  authority  given  was 
a  reference  to  his  lecture  delivered  before  a  Swedish  medical 
society  upon  a  certain  date.  Although,  so  far  as  known,  the 
facts  there  stated  have  never  been  denied,  yet  the  reference 
may,  perhaps,  be  called  indefinite.  But  one  case  is  not 
"many."  To  what  other  of  the  references  above  given  did 
you  refer  v/hen  you  informed  the  Senate  committee  that 
"many  of  them  are  so  vague  and  indefinite  that  I  could  not 
look  them  up  f  "  Had  you  stated  that  your  library  —  ample 
as  it  is  —  did  not  contain,  and  could  not  be  expected  to 
contain,  all  of  the  foreign  authorities  to  which  reference  was 
made,  there  would  have  been  nothing  to  criticize.  I  must 
assume,  sir,  that  you  have  not  put  forth  an  aspersion  of 
another's  reliability  merely  to  have  acknowledgment  of  the 
inadequacy  of  your  sources  of  reference;  that  the  proofs  of 
your  statement,  covering  "many^^  cases,  are  available,  and, 
in  the  interest  of  accuracy,  I  ask  you  to  produce  them. 

Second :  There  is  yet  another  point  to  which  I  ask  your 
attention.  You  made  the  statement  before  the  Senate  com- 
mittee that  in  regard  to  our  published  account  of  cases  of 
human  vivisection,  '*many  of  them  are  so  vague  and  indefin- 
ite that  I  could  not  look  them  up  ;  but,  as  to  those  that  I  could, 
some  are  garbled  and  inaccurate;  not  all  of  them,  observe." 

This,  sir,  is  a  most  serious  charge.  You  distinctly  de- 
clared that  of  the  cases  personally  investigated  by  yourself, 
as  quoted  in  the  pamphlet  on  "Human  Vivisection,"  some 
are  "garbled  and  inaccurate."  We  deny  the  charge,  and 
again  challenge  production  of  evidence  upon  which  it  is 
made. 

A  "garbled"  quotation  is  one  which,  by  reason  of  omis- 
sion and  perversions,  is  essentially  unfair.  Sometimes  it  is 
a  statement  from  which  parts  are  omitted  or  transposed  for 


AND  MEDICAL  PROGRESS  113 

the  purpose  of  conveying  a  false  impression.  To  omit  quo- 
tation of  parts  not  directly  bearing  upon  the  question  for 
the  sake  of  brevity  —  this  is  not  "garbling,"  for  all  quo- 
tations would  then  be  impossible.  We  assert  that  in  quot- 
ing accounts  of  the  cases  of  human  vivisecton  no  omissions 
of  essential  facts  have  been  made  sufficient  to  impair  the 
accuracy  or  fairness  of  the  quotation.  Let  us  put  the  mat- 
ter to  the  test.  Point  out,  if  you  can,  the  "some  cases'* 
which  you  found  "garbled  and  inaccurate,"  and  in  proof 
of  the  charge  quote  the  omitted  sentences  or  words  which,  had 
they  been  inserted,  would  cause  you  and  the  general  public  to 
justify  and  approve  the  experiments  on  human  beings  which 
we  have  so  severely  condemned. 

Third :  You  stated,  sir,  before  the  Senate  committee  that 
only  two  experiments  upon  human  beings  "are  alleged  to 
have  been  done  in  America."  I  question,  sir,  whether  that 
remark  is  quite  in  accord  with  the  highest  ideals  of  truth; 
it  is  the  language  of  doubt;  it  seems  to  signify  and  imply 
that  even  you  are  aware  of  no  other  experiments  upon  hu- 
man beings  than  two  cases  which  are  thus  "  alleged."  I  am 
very  confident,  sir,  that  you  will  not  venture  formally  to 
assert  —  what  you  have  seemed  to  imply  —  that  you  know 
of  but  two  experiments  upon  human  beings  made  in  this 
country  and  recorded  in  the  medical  literature  of  the 
United  States.  There  is,  indeed,  need  of  further  enlight- 
enment if  the  medical  profession  of  this  country,  so  worth- 
ily represented  by  yourself,  is  ignorant  of  what  has  been 
done  by  men  without  pity  and  without  conscience. 

Trusting  to  have  response  from  you  at  an  early  date, 
I  am. 

Yours  most  truly, 

James  M.  Brown,  President. 


114  ANIMAL  EXPERIMENTATION 

DR.   keen's  reply 

1729  Chestnut  Street, 
Philadelphia,  Pa.,  Jan.  21,  1901. 

James  M.  Brown,  Esq.,  President  American  Humane 
Association,  Toledo,  Ohio. 

Dear  Sir,  —  Your  letter  of  October  4  reached  me 
promptly,  but  as  I  then  notified  you  would  be  the  case, 
very  pressing  engagements,  absence,  etc.,  prevented  an 
earlier  reply.  Now  that  I  have  a  little  leisure,  I  can  answer 
your  letter  and  furnish  you  in  detail  the  proofs  for  which 
you  ask. 

There  are  two  pamphlets,  both  entitled  "Human  Vivi- 
section." First,  one  of  thirty  pages,  "printed  for  the  Amer- 
ican Humane  Association,  1899  ";  the  other  of  seven  pages, 
"published  by  the  Humane  Society,  Washington,  D.C.," 
without  date,  but  from  its  contents  published  a  little  later, 
as  it  is  chiefly  a  synopsis  of  the  same  instances  reported 
more  fully  in  the  larger  pamphlet.  Hereafter,  when  I  speak 
of  "the  pamphlet,"  I  mean  the  larger  one,  unless  I  spe- 
cifically mention  the  smaller  one. 

This  larger  pamphlet  consists  of  two  parts :  first  (pages 
3-12),  a  reprint  of  a  portion  of  Senate  Document  No.  78, 
and  the  rest  of  it  of  various  quotations,  translations,  and 
comments.  No  name  is  attached  to  either  part  to  indicate 
who  is  responsible  for  the  accuracy  of  the  references,  the 
translations,  or  the  quotations.  As  the  whole  is  preceded 
by  an  open  letter  signed  by  the  president  and  secretary  of 
the  American  Humane  Association,  and  as  you  refer  to  the 
pamphlet  as  "ours,"  I  presume  the  association  holds  itself 
responsible  for  such  accuracy,  especially  as  you  as  its  new 
president  challenge  me  for  proof. 

The  pamphlet  purports  to  furnish  a  reprint  of  a  portion 
of  Senate  Document  No.  78  and  refers  to  this  document 
in  a  way  that  would  lead  uninformed  readers  to  suppose 
that  this  is  a  document  expressing  the  sentiments  of  the 
United  States  Senate.    It  is,  therefore,  important  to  call 


AND  MEDICAL    PROGRESS  115 

your  attention  to  the  fact  that  Senate  Document  No.  78  is 
simply  a  collection  of  statements  and  papers  by  various 
persons,  printed  by  order  of  the  Senate,  but  in  no  sense  ex- 
pressing the  opinions  or  convictions  of  that  body.  The  last 
paper  in  Document  No.  78  is  one  on  "Human  Vivisection," 
by  "A.  Tracy." 

In  two  respects  "A.  Tracy"  has  a  right  to  complain  that 
the  reprint  is  inaccurate:  First,  it  omits  to  print  the  name 
of  the  author,  "A.  Tracy."  ^  Surely  he  —  or  she(?)  — 
should  receive  whatever  credit  there  is  attaching  to  his 
work.  Secondly,  on  page  30,  line  8,  of  Senate  Document 
No.  78,  I  read,  "A.  Tracy's  comment."  ["This  patient, 
therefore,  was  scientifically  murdered."]  This  statement 
the  reprint  very  wisely  omits  —  but  there  are  no  indica- 
tions of  the  omission.  Of  this,  more  hereafter. 

Your  letter  challenges  the  accuracy  of  my  statements  in 
three  particulars:  (1)  I  stated  that  many  of  the  references 
in  the  pamphlet  are  "vague  and  indefinite";  (2)  I  said  that 
some  of  the  accounts  of  the  experiments  are  "garbled  and 
inaccurate";  (3)  I  stated  that  of  the  experiments  narrated 
in  the  pamphlet  only  two  were  alleged  to  have  been  per- 
formed in  America. 

You  will  pardon  me  if  I  indignantly  resent  your  imputa- 
tion of  untruthfulness  in  regard  to  this  last  statement.  You 
entirely  misinterpret  my  statement,  which  had  no  reference 
to  my  knowledge  or  ignorance  of  any  other  American  ex- 
periments. I  said  that  the  pamphlet  only  contained  two 
instances  of  such  experiments  which  were  alleged  to  have 
been  done  in  America.  These  are  recorded  on  pages  4  and 
5  of  the  pamphlet.  All  the  rest  were  done  in  Europe,  South 

*  In  Watson's  Physicians  and  Surgeons  of  America,  Dr.  Albert  Leffing- 
well's  full  name  is  given  as  "Albert  Tracy  LeflSngwell."  In  the  same 
article  it  is  noted  that  a  book  of  his,  "Rambles  through  Japan  without 
a  Guide,"  came  out  in  London  in  1892  under  the  pseudonym  of  "Albert 
Tracy."  In  the  Catalogue  of  the  Surgeon-General's  Library  Dr.  LelBSng- 
well's  name  is  given  as  "Albert  (Tracy)  Leffingwell."  In  his  own  book 
on  Vivisection  his  name  is  only  "Albert  LeflSngvzell."  (1914.) 


116  ANIMAL  EXPERIMENTATION 

America,  and  Hawaii,  years  before  it  came  into  our  pos- 
session. If  you  still  question  the  accuracy  of  my  statement 
and  believe  that  there  is  a  third  instance  of  experiments 
done  in  America,  and  described  in  the  pamphlet,  point  it 
out  by  page  and  paragraph. 

Turning  to  the  other  two  really  important  matters  re- 
ferred to  in  your  letter,  let  me  again  state  clearly  the  question 
at  issue.  It  is  not  whether  the  experiments  meet  with  my  ap- 
proval, but  solely  whether  the  reports  of  them  in  the  pamphlet 
issued  by  the  American  Humane  Association  are  reliable  and 
accurate  both  as  to  their  sources  and  substance. 

1.  Many  of  the  References  are  Vague  and  Indefinite 

The  references  are  so  vague  and  indefinite  in  many  cases 
that  the  statements  and  quotations  made  cannot  be  veri- 
fied by  consulting  the  originals.  The  preface  of  your  presi- 
dent and  secretary  states  that  "in  each  case  the  authority  is 
given,"  and  what  sort  of  "authority"  do  you  depend 
upon?  Newspaper  medicine  and  surgery  are  notoriously 
inaccurate.  I  have  personally  had  so  much  experience  and 
observation  of  this  that  I  am  always  certain  that  at  least 
one  half  or  more  of  the  statements  in  newspapers  in  refer- 
ence to  medical  matters  are  inaccurate,  not  purposely,  but 
only  because  the  writers  are  not  medical  men.  Yet  you 
depend  for  the  accuracy  of  your  statements  upon  news- 
papers as  follows  (I  follow  the  inaccurate  spelling  of  foreign 
names  in  your  pamphlet) :  — 

1.  The  Vienna  correspondent  of  the  London  Morning  Leader, 
January  26,  1899  (p.  3),  of  whom  more  hereafter. 

2.  The  Deutsche  VolksblaM,  January  25,  1899  (p.  3). 

3.  The  Washington  correspondent  of  the  Boston  Transcript^ 
September  24,  1897  (p.  9),  of  whom  more  hereafter. 

4.  The  New  York  Independent,  December  12,  1895  (p.  11). 

5.  The  London  Times,  June  27,  1891  (p.  16). 

6.  The  Tagliche  Rundschau  of  Berlin  (p.  17) ;  no  year,  month, 
or  day  being  given. 

7.  The  Vossische  Zeitung,  of  Berlin,  no  year,  month,  or  day  being 
given  (p.  18). 


AND  MEDICAL    PROGRESS  117 

8.  The  Vorwartz,  no  year,  month,  or  day  being  given  (p.  18). 

9.  The  Danziger  Zeitung,  July  23,  1891  (p.  18). 

10.  The  Schlesische  Volkszeitung,  July  24,  1891  (p.  18). 

11.  The  Hamburger  Nachrichten,  July,  1891,  no  day  stated 

(p.  19). 

12.  A  correspondent  of  the  Newcastle  (England .'')  Daily  Chron- 
icle, September  21,  1888  (p.  22). 

13.  Dr.  R.  E.  Dudgeon,  in  the  Abolitionist,  April  15,  1899 
(p.  24). 

14.  A  letter  by  Dr.  Edward  Berdoe  to  the  London  Chronicle , 
vnthout  year,  month,  or  day  (p.  29). 

Few  of  these  fourteen  newspaper  references  can  be  con- 
sulted in  this  country;  five  of  them  (numbers  6,  7,  8,  11, 
and  14)  are  impossible  of  consultation  for  want  of  any  date 
whatever. 

In  no  case  would  I  be  willing  to  admit  a  newspaper  para- 
graph, a  non-professional  and  usually  unsigned  statement, 
• —  even  if  correctly  quoted,  —  as  a  sufficient  authority  for 
a  grave  charge  against  an  individual  or  the  profession. 

Look  for  a  moment  what  stuff  Senator  Gallinger  stated 
at  the  "Hearing"  he  had  himself  caused  to  be  printed.  It 
is  published  on  page  31  of  the  "Hearing"  and  on  page  3  of 
the  pamphlet.  It  consists  of  cable  dispatches  printed  in 
some  newspaper  —  Senator  Gallinger  did  not  even  remem- 
ber its  name.  The  author  of  the  dispatch  from  London  is 
utterly  unknown.  The  dispatch  states  that  "the  Vienna 
correspondent  of  the  [London]  *  Morning  Leader'  says  **  so 
and  so.  Who  and  how  reliable  is  the  Vienna  correspondent? 
He  says  that  "the  physicians  in  the  free  hospitals  of  Vi- 
enna "  do  so  and  so.  Who  are  the  physicians?  In  what  hos- 
pitals were  these  deeds  of  darkness  done? 

And  upon  such  evidence  it  is  seriously  proposed  to  indict 
the  medical  profession!  Whether  these  dispatches  are 
"garbled  and  inaccurate"  in  their  alleged  facts,  who  can 
find  out? 

If  a  lawyer  tried  to  convict  a  man  of  petty  larceny  on 
such  testimony,  he  would  be  laughed  out  of  court.    And 


118  ANIMAL  EXPERIMENTATION 

yet  a  Senator  of  the  United  States  and  the  American  Hu- 
mane Association  actually  adduce  such  statements  as  evi- 
dences of  the  gravest  charges  and  spread  them  broadcast ! 
I  now  add  six  other  "vague  and  indefinite"  references 
not  to  newspapers. 

15.  On  page  13  there  is  a  quotation  from  TertuUian. 
The  reference  in  the  footnote  is  "TertuUian,  De  Anima, 
vol.  II,  pp.  430,  433,  Tran.  by  Holmes.'*  I  have  compared 
the  quotation  with  Clark's  Edinburgh  edition  of  the  Trans- 
lation of  TertuUian  by  Holmes,  the  date  of  the  edition  be- 
ing 1870.  No  such  quotation  exists  on  pages  430-433. 
Possibly  it  may  be  that  the  quotation  is  from  another  edi- 
tion. No  edition  is  named  in  the  pamphlet;  another  in- 
stance of  a  "vague  and  indefinite"  reference. 

16.  On  page  17  a  formal  accusation  is  quoted  as  made  by 
a  Dr.  Eugen  Leidig  against  certain  surgeons.  No  reference 
whatever  to  any  book  or  journal  is  given  by  which  the  accur- 
acy of  the  quotation  can  be  tested.  Is  not  this  again  * '  vague 
and  indefinite".? 

17.  On  page  24  is  a  reference  to  a  paper  by  "  Professor  E. 
Finger,  of  Vienna  {Allg.  Wiener  med.  Zeitung,  nos.  50  and 
51 ") .  No  year  is  given,  a  somewhat  essential  part  of  the  ref- 
erence, as  there  are  over  forty  volumes  of  this  journal,  each 
with  the  weekly  numbers  50  and  51.  No  such  paper  by 
Finger  is  published  in  that  journal,  at  least  from  1890  to 
the  present  time.  The  reference  is  quoted  from  a  paper  by 
Dr.  R.  E.  Dudgeon  in  the  "Abolitionist" — ^  an  English 
journal  —  of  April  15, 1899.  I  have  been  unable  to  consult 
this  journal.  If  Dudgeon  gave  the  year,  then  the  Humane 
Association  pamphlet  has  misquoted  him.  If  he  did  not, 
then  both  the  association's  pamphlet  and  he  have  been 
"vague  and  indefinite." 

18.  On  page  25  again  is  a  reference  to  a  statement  in  a 
"lecture  before  the  Medical  Society  of  Stockholm,"  by  Dr. 
Jansen,  of  the  Charity  Hospital,  reporting  certain  experi- 
ments.    No  reference  whatever  is  given  even  to  a  news- 


AND  MEDICAL  PROGRESS  119 

paper,  much  less  to  any  medical  journal.  As  the  statement 
is  in  quotation  marks  it  purports  to  be  the  exact  words  used 
and  ought  to  have  had  some  source  to  which  a  reference  was 
possible,  especially  as  the  preface  of  the  pamphlet  says: 
"In  each  case  the  authority  is  given."  I  am  glad  to  see  that 
in  your  letter  you  recognize  this  as  one  in  which  the  refer- 
ence is  really  inadequate.  I  notice,  however,  that  even  in 
your  letter  you  do  not  supply  this  missing  reference.  You 
say  the  facts  asserted  in  the  Jansen  paragraph  have  never 
been  denied.  Of  course  not.  The  first  requisite  is  to  know 
whether  they  are  correctly  quoted. 

Turning  now  from  the  larger  pamphlet  to  the  smaller 
one,  which  was  spread  broadcast  by  house-to-house  distri- 
bution in  Washington  at  the  time  when  the  hearing  on  this 
matter  took  place  last  winter,  I  find  repeated  in  this  a  num- 
ber of  the  same  vague  and  indefinite  references  and  garbled 
and  inaccurate  quotations  already  or  to  be  described,  to 
which  are  to  be  added  the  following:  — • 

19.  On  page  3,  an  extract  from  a  report  referring  to  ex- 
periments upon  insane  patients  is  printed  in  quotation 
marks.  The  only  reference  is  to  a  "published  report"  in 
1890  of  the  "Medical  Staff  of  the  Public  Insane  Asylum  in 
Voralberg,  Austria."  The  librarian  of  the  Surgeon-Gen- 
eral's office  informs  me  that  there  are  two  small  insane 
asylums  in  the  Voralberg,  namely,  at  Hall  and  Valduna. 
Some  reports  of  the  former  are  in  the  library,  and  in  them 
no  account  of  the  experiments  referred  to  can  be  found. 
No  reply  has  been  received  to  a  letter  addressed  to  this 
asylum  as  named  in  the  pamphlet,  and  written  over  a  year 
ago.i 

20.  On  the  same  page  is  an  account  of  some  experiments 
on  bacteria  from  boils,  and  the  reference  is  to  the  "Deut- 
sches  Volksblatt";  no  day,  no  month,  no  number,  no  page, 
nor  even  the  year  is  given.  If  this  is  not  "  vague  and  indefin- 
ite," what  is? 

^  This  letter  was  written  by  myself  and  not  by  the  librarian. 


120  ANIMAL  EXPERIMENTATION 

21.  On  page  24  there  is  an  account  of  Kroenig's  experi- 
ments, to  which  I  shall  recur  later.  No  reference  whatever 
is  given  to  the  source  from  which  the  account  is  taken. 

2.  Some  of  the  Statements  are  Garbled  and  Inaccurate 

To  be  vague  and  indefinite  in  charges  affecting  the  morals 
and  the  reputation  not  only  of  individuals,  but,  in  fact,  of 
a  whole  profession  is  bad  enough,  but  to  make  statements 
that  are  "garbled  and  inaccurate**  is,  as  your  letter  recog- 
nizes, a  much  more  serious  matter.  Let  me  consider  the 
instances  in  detail. 

1.  "Vivisection  Experiments  upon  the  Insane,**  pages  4 
and  5 :  In  the  following  quotation,  the  words  of  the  original, 
which  I  inclose  in  brackets,  are  omitted.  "To  these  pa- 
tients the  thyroid  tablets  [each  pill  representing  five  grains 
of  the  fresh  sheep's  gland]  were  administered,**  etc.  This 
omission  is  of  moment,  because  any  one  familiar  with  the 
administration  of  thyroid  extract  knows  that  the  doses 
used  by  Dr.  Berldey  are  frequently  given  to  human  pa- 
tients, including  the  insane,  without  producing  symptoms 
dangerous  to  life,  but,  on  the  contrary,  with  benefit.  I 
have  myself  given  such  tablets  to  patients  with  goiter  for 
weeks  together  in  larger  doses  than  Dr.  Berkley  used. 

In  the  following  paragraph  the  quotation  is  garbled  by 
omitting  the  words  which  I  inclose  in  brackets:  "Two  pa- 
tients became  frenzied  and  of  these  one  died  before  the 
excitement  had  subsided  [the  immediate  cause  of  the  exitus 
being  an  acute  disseminated  tuberculosis].**  And  again  in 
the  next  paragraph  giving  a  report  of  the  same  case,  the 
pamphlet  quotes:  "The  thyroid  extract  was  now  discon- 
tinued, but  the  excitement  kept  up  .  .  .  for  seven  weeks, 
at  the  end  of  which  time  she  died.'*  One  would  think  this 
was  the  end  of  the  sentence  and  that  she  died  from  the 
effects  of  the  thyroid  tablets.  Not  at  all.  The  original  con- 
tinues as  follows:  She  died  "with  the  clinical  evidences 
of  acute  miliary  tuberculosis'* — galloping  consumption. 


AND  MEDICAL  PROGRESS  121 

Does  this  not  come  within  the  definition  of  garbling  given 
in  your  letter?  "A  *  garbled'  quotation  is  one  which,  by 
reason  of  omission  and  p>erversions,  is  essentially  unfair." 
To  say  that  this  patient,  who  actually  died  of  galloping 
consumption,  died  from  the  eflFects  of  the  thyroid  extract, 
which  had  not  been  given  for  seven  weeks  before  death,  is 
as  absurd  as  it  would  be  to  say  she  had  died  from  the  effects 
of  moderate  doses  of  laudanum  given  seven  weeks  before. 
Yet  "A.  Tracy's"  comment  on  this  case  is:  ["This  patient 
was,  therefore,  scientifically  murdered."]  Your  Association 
mutilates  its  reprints  by  wisely  omitting  this  piece  of  ab- 
surdity, though  the  omission  is  not  indicated.  Moreover, 
the  pamphlet  states:  "There  is  no  intimation  that  the  ad- 
ministration of  the  poisonous  substance  was  given  for  any 
beneficial  puipose  to  the  patients,  for  he  took  care  to  select 
patients  that  were  probably  incurable."  On  the  contrary, 
Berkley's  original  paper  expressly  states  that  instead  of 
being  incurable,  one  (case  1)  was  cured  and  another  (num- 
ber 3)  was  improved.  Besides  this,  though  the  pamphlet  is 
dated  1899,  it  omits  all  reference  to  Dr.  Berkley's  letter  to 
the  "British  Medical  Journal"  for  October  30,  1897,  in 
reply  to  your  friend  Dr.  Berdoe,  which  shows  that,  as  a  re- 
sult of  the  administration  of  the  thyroid  tablets  to  these 
eight  patients  —  a  well-recognized  remedy  for  insanity,^ 
not  one  died  from  the  effects  of  the  drug,  but  that,  on  the 
contrary,  two  of  those  alleged  "incurables"  were  cured  — 
twenty-five  per  cent. 

In  his  admirable  letter  to  "Life,"  —  December  6,  1900, 
—  Dr.  Berkley  says:  "The  purpose  for  which  the  article 
was  written  was  to  show  to  the  medical  profession  that  a 

*  I  quote  the  following  from  the  eighth  edition  of  Hare's  Therapeuticg, 
as  to  the  use  of  thyroid  extract :  "  In  the  dose  of  from  five  to  twenty  grains 
(0.S5-1.3)  three  times  a  day  [i.e.,  fifteen  to  sixty  grains  a  day]  according 
to  the  degree  to  which  it  produces  its  effects,  it  has  proved  of  value  in 
acute  mania  and  melancholia,  puerperal  and  climacteric  insanities,  and  in 
stuporous  states  with  primary  dementia."  Berkley's  maximum  dose  was 
fifteen  grains  a  day. 


1£2  ANIMAL  EXPERIMENTATION 

certain  medicament  in  common  use  was  not  free  from  objec- 
tion, and  should  not  be  given  in  unsuitable  cases.  In  proper 
ones  the  results  are  among  the  most  resplendent  attained 
by  modern  medicine,  converting  the  drooling  dwarf  into 
an  intelligent,  well-grown  man  or  woman;  or  in  other  in- 
stances, as  in  myxedematous  insanity,  affording  the  other- 
wise hopelessly  insane  with  almost  a  specific  to  recover 
their  reason."  (See  the  addendum  at  the  end  of  this  let- 
ter.) 

2.  The  "Cases  of  Lumbar  Puncture,"  by  Dr.  Went- 
worth,  of  Boston  (p.  5) :  *  "Lumbar  puncture,"  I  may  re- 
mind you,  is  the  simple  insertion  of  a  hypodermic  needle 
between  the  vertebrae  into  the  sheath  of  the  spinal  cord, 
but  below  the  cord  itself,  to  obtain  a  few  drops  of  the  cere- 
bro-spinal  fluid  for  diagnosis. 

The  pamphlet  gives  what  is  called  a  "brief  abstract"  of 
five  of  the  experiments  related.  The  abstracts  are  indeed 
brief,  so  brief  as  to  give  a  wholly  erroneous  impression  as  to 
the  causes  of  the  patients'  death.  The  omissions  are  glaring 
instances  of  what  the  logicians  call  a  suppressio  veri  equiv- 
alent to  a  suggestio  falsi.   Let  me  point  this  out  in  detail. 

Case  2.  It  is  correctly  quoted  that  the  last  puncture 
(where  there  were  several  punctures  I  only  give  the  last 
date)  was  made  "February  16,  on  the  day  of  the  patient's 
death."  The  pamphlet  fails  to  add,  however,  the  important 
fact  stated  by  Dr.  Wentworth  that  the  post-mortem  showed 
an  empyema  [abscess  in  the  chest]  which  had  burst  into  the 
lung,  pneumonia,  and  inflammation  of  the  brain  with  pus 
as  the  causes  of  death. 

Case  3.  The  pamphlet  correctly  says:  "Puncture  Jan- 
uary 17, 1896;  patient  died  January  22."  What  Dr.  Went- 
worth adds  is  omitted,  namely:  "No  symptoms  attended 
or  followed  the  operation."    Moreover,  the  post-mortem 

1  For  a  further  discussion  of  the  cases  of  Dr.  Wentworth,  due  to  later 
and  still  worse  misstatements,  see  "The  Influence  of  Antivivisection  on 
Character,"  Tposi,  pp.  274-278. 


AND  MEDICAL  PROGRESS  123 

showed  that  the  patient  died  from  the  widespread  changes 
common  to  infantile  wasting. 

Case  5.  The  pamphlet  says:  "Puncture  February  3, 
1896;  patient  died  February  4.'*  It  omits  to  state  what  im- 
mediately afterward  follows,  that  the  post-mortem  showed 
"primary  tuberculosis  of  the  intestines.  Double  pneu- 
monia," as  the  causes  of  death. 

Case  6.  The  pamphlet  quotes:  "Puncture  February  1; 
patient  died  in  convulsions  three  weeks  later."  It  neglects 
to  state  what  Dr.  Wentworth  particularly  mentions,  "no 
reaction  on  the  part  of  the  patient  attended  the  operation," 
and  it  also  fails  to  state  that  the  child  was  seen  only  once, 
and  that  the  diagnosis  then  made  was  tuberculous  menin- 
gitis, which  was  clearly  the  cause  of  the  child*s  death, 
three  weeks  later. 

Case  7.  The  pamphlet  quotes:  "Punctured  February 
27;  patient  died  February  28."  It  omits  the  fact  that  the 
post-mortem  showed  that  the  child  died  from  defective  de- 
velopment of  the  brain  and  other  causes;  and  that  the  his- 
tory showed  that  the  child,  who  was  seven  months  of  age, 
had  "frequent  convulsions,  which  began  when  he  was  about 
three  months  old.  While  in  the  hospital  the  convulsions 
occurred  not  less  than  twenty  times  a  day.  Oftentimes  he 
had  several  in  an  hour." 

The  inference  from  the  pamphlet's  "brief  abstracts"  of 
these  cases  is  clearly,  and  it  seems  to  me  by  these  omissions 
was  meant  to  be,  that  the  deaths  were  due  to  the  lumbar 
punctures,  whereas  the  evidence  is  that  the  deaths  were  due 
to  other  causes,  and  in  two  instances  the  operation  is  ex- 
pressly stated  not  to  have  done  any  harm.  Are  not  these 
abstracts  "garbled  and  inaccurate"? 

3.  On  page  7  the  pamphlet  refers  to  some  experiments  on 
the  inoculation  of  lepers  with  syphilis,  made  in  Hawaii,  but 
pubHshed  in  the  "New  York  Medical  Record"  of  Septem- 
ber 10,  1892.  It  is  stated  that  the  patients  "were  already 
suffering  from  one  incurable  disease  and  the  object  of  the 


lU  ANIMAL  EXPERIMENTATION 

experiment  was  to  ascertain  whether  with  another,  and 
even  worse,  disorder,  they  might  not  be  infected.'*  This 
statement  is  incorrect.  Most  writers  recognize  only  three 
stages  of  syphilis,  primary,  secondary,  and  tertiary.  The 
writer  of  the  article  in  question  believed  that  leprosy  was  a 
fourth  and  final  stage  of  syphilis  and  not  an  independent 
disease.  It  is  a  well-recognized  fact  by  all  scientific  writers 
that  a  patient  suffering  from  syphilis  in  any  stage  is  im- 
mune to  an  inoculation  of  the  virus;  that  is  to  say,  the  in- 
oculation will  not  "take"  if  he  is  already  a  syphilitic.  It 
was  for  the  purpose  of  determining  whether  leprosy  was  a 
fourth  stage  of  syphilis  that  the  attempt  was  made.  None 
of  those  inoculated  took  the  disease. 

4.  Sanarelli's  "Experiments  on  the  Inoculation  of  Yel- 
low Fever,"  page  8:  The  references  here  are  to  the  "Brit- 
ish Medical  Journal"  for  July  3, 1897,  and  the  "New  Eng- 
land Medical  Monthly,"  March,  1898.  The  extracts 
marked  with  quotation  marks  are  from  the  "New  England 
Medical  Monthly."  Between  the  first  and  the  second  sen- 
tences of  the  quotation  there  should  be  some  stars  to  note 
an  omission,  but  none  such  appear.  The  omitted  words 
state  that  not  the  germs  of  the  disease,  but  the  carefully 
filtered  and  sterilized  germ-free  fluid  was  used.  Besides 
this  and  many  other  minor  inaccuracies  many  of  the  scien- 
tific terms  are  changed  into  non-medical  terms,  which  is 
not  objectionable  in  itself.  But  such  changes  and  inaccur- 
acies should  exclude  quotation  marks,  for  when  used  they 
mean  that  the  words  quoted  are  the  ipsissima  verba  of  "the 
author,  if  in  the  same  language,  or  an  exact  translation  if 
from  a  foreign  language. 

But  this  is  the  least  of  all.  The  pamphlet  says  that  the 
injection  produced  certain  symptoms,  among  which  are 
mentioned  "  the  jaundice,  the  delirium,  the  final  collapse^** 
the  last  three  words  being  in  italics  in  the  pamphlet  to  call 
special  attention  to  them.  In  the  "British  Medical  Jour- 
nal," and  in  the  "New  England  Medical  Monthly"  the 


AND  MEDICAL  PROGRESS  125 

words  "  the  final "  are  not  to  be  found.  We  see  not  a  few  pa- 
tients suffering  from  "jaundice,  delirium,  and  collapse" 
who  recover,  but  when  the  expression  is  changed  to  "the 
final "  collapse,  it  means  to  every  one  that  the  patient  died. 

Moreover,  the  end  of  the  quotation  is  as  follows :  "  I  have 
seen  [the  symptoms  of  yellow  fever]  unrolled  before  my 
eyes  thanks  to  the  potent  influence  of  the  yellow  fever 
poison  made  in  my  laboratory."  This  entire  sentence  does 
not  occur  either  in  the  "British  Medical  Journal"  or  in  the 
"New  England  Medical  Monthly."  Whether  it  is  quoted 
from  some  other  source  not  indicated,  or  has  been  deliber- 
ately added,  I  leave  you  or  "  A.  Tracy  "  to  explain. 

Moreover,  immediately  afterward,  on  the  authority  of 
the  Washington  correspondent  of  the  Boston  "Transcript," 
it  is  stated:  "It  is  understood  that  some,  if  not  all,  of  the 
persons  inoculated  died  of  the  disease " ;  and  then  seven 
times  afterward  are  repeated  "the  final  collapse,"  the  "un- 
rolling before  the  eyes,"  "  scientific  assassination,"  "death," 
and  "murder,"  quoted  from  a  public  speech  before  the 
American  Humane  Association.  Let  us  see  if  these  were 
"murders." 

In  the  two  references  given  there  is  no  indication  whether 
any  of  these  patients  died  or  not.  How,  therefore,  "it  is 
understood  that  some,  if  not  all,  of  them  died,"  I  do  not 
know.  As  a  matter  of  fact  none  of  the  human  beings  inocu- 
lated by  Sanarelli  died,  as  any  one  desirous  of  learning  the 
truth  could  have  ascertained  by  consulting  Sanarelli's 
original  publication  reporting  his  experiments  with  full 
details.^ 

What  hysterical  oratory  about  "the  final  collapse," 
which  was  not  final;  "scientific  assassination,"  which  did 
not  assassinate;  and  "murder"  of  those  who  were  so  dis- 
obliging as  still  to  live  I  And  this  on  the  authority  of  the 
Washington  correspondent  of  the  Boston  "Transcript," 

^  Annali  d'Igiene  Sperimentale,  1897,  vol.  vii,  Fascic:  iii,  pp.  345 
and  433. 


126  ANIMAL  EXPERIMENTATION 

who,  the  pamphlet  assures  us,  is  a  person  "who  would 
seem  to  be  unusually  well  informed  in  matters  of  science"  ! 
An  excellent  example  of  "newspaper  medicine*'  and  a  good 
reason  for  my  refusal  to  accept  it  as  evidence,  especially 
from  other  correspondents  who  may  not  be  as  "unusually 
well  informed.'*  May  I  ask  whether  "the  Vienna  corre- 
spondent of  the  London  *  Morning  Leader'"  is  also  one  of 
those  who,  in  your  opinion,  is  "  unusually  well  informed  in 
matters  of  science,"  and  whether  his  testimony  is  as  wholly 
false  as  the  one  under  consideration? 

5.  On  page  23,  the  pamphlet  quotes  an  account  of  some 
experiments  of  Dr.  Neisser  from  the  "Medical  Press  and 
Circular  [England],  of  March  29,  1899."  This  is  an  in- 
stance again  of  misquotation  and  omission  which  can 
scarcely  be  other  than  intentional.  The  last  sentence  of  the 
first  quotation  states:  "Of  these  eight  girls,  four  developed 
syphilis."  No  stars  indicate  that  any  words  have  been 
omitted.  The  original  reads:  "Of  these  eight  girls  [five 
were  prostitutes,  and  of  these  five]  four  developed  syphilis." 
The  words  in  brackets  are  entirely  omitted  in  the  pamphlet. 
They  make  a  deal  of  difference,  for  what  is  more  probable 
than  that  four  out  of  five  prostitutes  should  develop  syph- 
ilis? Whether  it  makes  any  difference  or  not,  however,  is  at 
present  not  the  question.  The  issue  is  whether  the  quota- 
tion is  "garbled  and  inaccurate."  Does  it  not  fulfill  another 
of  the  definitions  of  "garbling"  given  in  your  letter, 
namely,  "omissions  of  essential  facts  .  .  .  sufficient  to  im- 
pair the  accuracy  or  fairness  of  the  quotation"  ? 

Moreover,  the  pamphlet's  comment  upon  this  case  is  as 
follows :  — 

"Does  the  London  journal  which  reports  these  awful 
experiments  denounce  them  as  a  crime  against  every  law 
of  morality?  Not  at  all.  It  simply  says  that  *it  would  be 
difficult  to  acquit  Dr.  Neisser  of  a  large  measure  of  re- 
sponsibility in  respect  of  the  causation  of  syphilis  in  these 
cases'!    Could  reproof  be  more  gentle?" 


AND  MEDICAL  PROGRESS  127 

Is  that  really  all  that  the  "Medical  Press  and  Circular" 
"simply  says  "?  On  turning  to  that  journal,  after  the  above 
sentence,  which  is  correctly  quoted,  the  editorial  continues 
thus :  "  We,  however,  are  less  concerned  in  establishing  the 
culpabiHty  of  Dr.  Neisser  than  in  condemning  the  spirit 
which  prompted  such  experiments.  All  measures,  even  if 
novel,  which  may  reasonably  be  expected  to  assist  in  bring- 
ing about  the  recovery  of  the  patient  without  injury  to  his 
health  may  legitimately  be  resorted  to  with  the  consent  of 
the  patient,  but  measures,  whether  by  drugs  or  by  opera- 
tion, which  have  not  for  direct  object  the  cure  of  the  patient 
and  which  may  prove  inimical  to  his  health  or  condition, 
are  inadmissible  under  any  circumstances  and  must  expose 
the  perpetrator  to  professional  ostracism  and  to  penal  re- 
buke." 

Is  "professional  ostracism  and  penal  rebuke"  a  reproof 
than  which  nothing  could  be  "more  gentle"?  If  this  state- 
ment is  not  "garbled  and  inaccurate,"  what  do  words 
mean?  How  could  this  misrepresentation  be  otherwise 
than  intentional? 

6.  On  page  24  again,  reference  is  made  to  the  experiments 
of  Menge.i  The  extracts  being  in  quotation  marks  would 
purport  to  be  exact  translations.  This  is  not  the  case.  The 
collocation  of  the  paragraphs,  also,  —  especially  in  the 
smaller  pamphlet,  —  is  such  that  it  would  be  supposed 
even  by  a  careful  reader  that  the  babies  experimented  upon 
were  inoculated  with  the  germs  taken  "from  the  pus  in  the 
abdominal  cavity  of  a  person  who  had  died  of  peritonitis," 
without  any  precautions  or  preliminary  experiments,  and 
that,  therefore,  these  babies  were  exposed  to  a  fatal  infec- 
tion. This  is  not  true.  Four  columns  of  text  in  the  original 
intervene  between  the  first  and  the  second  paragraphs 
alleged  to  be  quoted,  and  these  detail  experiments  which 
proved  that  the  inoculations  which  he  then  carried  out 
would  almost  certainly  be  harmless.    The  result  showed 

^  Deutsche  medicinische  Wochenschrift,^  1894,  noa.  46  to  43. 


128  ANIMAL  EXPERIMENTATION 

that  he  was  right,  for  not  the  slightest  ill  effects  followed. 
I  have  only  words  of  condemnation  for  Menge's  experi- 
ments, but  to  misrepresent  these  experiments  is  scarcely 
less  culpable  than  to  perform  them. 

7.  Then  follows  a  brief  account  of  Kroenig's  experiments. 
The  objects  of  these,  the  pamphlet  says,  were  "  to  observe 
the  surest  way  of  breeding  purulent  bacteria."  This  is  not 
true.  On  the  contrary,  his  object,  like  Menge's,  was  to  de- 
termine how  these  bacteria  are  normally  destroyed  in  the 
part  of  the  body  in  which  the  experiments  were  made.  In 
only  a  single  instance  did  any  ill  effects  follow,  and  in  this 
case  the  inflammation  was  brief  and  not  dangerous  either 
to  life  or  health.  In  fact,  the  very  titles  of  these  two  papers 
proclaim  the  destruction  of  the  bacteria  and  not  the  surest 
way  of  breeding  them.  Menge*s  title  reads:  "On  a  quality 
(Ferhalten)  of  the  vaginal  secretion  in  non-pregnant  fe- 
males, which  is  hostile  to  bacteria";  and  Kroenig's  is  on 
the  same  peculiarity  in  pregnant  women. 

In  the  comment  on  these  two  series  of  experiments,  they 
are  spoken  of  as  inoculations  "with  loathsome  diseases," 
which  would  suggest  to  any  one  that  the  patients  were  suc- 
cessfully inoculated  with  syphilis  or  other  similar  diseases. 
This  was  not  the  case.  Only  inflammation  would  follow 
even  had  the  inoculations  been  successful. 

Moreover,  to  show  the  vague  looseness  of  the  alleged 
quotations,  the  two  paragraphs  on  the  experiments  of 
Menge  are  in  quotation  marks  and  are  introduced  by  the 
words,  "He  says:  The  bacteria  I  used,"  etc.,  as  if  they  were 
exact  continuous  translations.  "He  says"  nothing  of  the 
kind.  Instead  of  being  exact  translations,  the  first  para- 
graph is  made  up  of  partly  correct  and  partly  incorrect 
translations  from  page  891,  near  the  top  of  the  second 
column  and  near  its  middle;  and  the  second  paragraph  of 
partly  correct  and  partly  incorrect  translations  from  page 
907,  near  the  bottom  of  the  first  column. 

No  reference  whatever  is  given  to  Kroenig's  paper  either 


AND  MEDICAL  PROGRESS  129 

by  number,  date,  or  page.  Is  not  this  "vague  and  indef- 
inite"? As  a  matter  of  fact,  it  is  the  same  journal  (no. 
43,  p.  819)  as  Menge*s  paper,  but  published  three  weeks 
earlier. 

8.  On  page  25  is  one  of  the  most  outrageous  instances  of 
garbling,  and  mistranslation,  or  worse,  which  I  have  ever 
known  to  be  perpetrated,  even  in  antivivisectionist  publi- 
cations. It  relates  to  observations  and  experiments  of  Pro- 
fessor Schreiber,  reported  in  the  "Deutsche  medicinische 
Wochenschrift"  of  February  19,  1891.  The  subject  is  in- 
troduced with  the  startling  caption:  "Inoculations  with 
Tuberculin  and  Germs  of  Consumption."  In  the  smaller 
pamphlet  the  caption  is  simply :  "  Injected  Germs  of  Con- 
sumption." What  was  injected  was  not  the  "germs  of  con- 
sumption" at  all,  but  tuberculin,  a  substance  which  at  the 
date  of  Professor  Schreiber's  publication  was  engaging  the 
attention  of  physicians  throughout  the  civilized  world  as  a 
therapeutic  and  diagnostic  agent.  To  describe  inoculations 
with  tuberculin  as  "inoculations  with  the  germs  of  con- 
sumption" can  be  attributed  only  either  to  gross  ignorance 
or  to  willful  disregard  of  the  truth. 

In  the  first  paragraph  occurs  the  sentence:  "He  began 
with  one  decimilligram  and  continued  to  inject  the  tuber- 
culin in  ever-increasing  quantities,  until  he  at  last  injected 
as  much  as  five  centigrams,  about  fifty  times  as  much  as 
Koch  said  was  the  maximum  dose  for  children  of  three  to 
five  years  old."  Any  fair  presentation  of  these  experiments 
would  have  included  Professor  Schreiber's  sentence,  which 
he  prints  in  bold-face  type:  "But  even  with  so  large  a  dose 
injected  at  one  time,  the  children  showed  no  trace  oj  a 
reaction."  It  would,  perhaps,  be  too  much  to  expect  your 
society  to  have  indicated  on  what  grounds  Professor 
Schreiber  was  led  to  the  employment  of  such  large  doses, 
and  that  his  observations  demonstrated  for  young  infants 
an  exceptional  tolerance  of  tuberculin,  a  phenomenon  for 
which  there  are  analogies  with  other  drugs. 


130  ANIMAL  EXPERIMENTATION 

But  the  worst  falsification  is  the  succeeding  account,  in 
the  form  of  what  purports  to  be  an  exact  translation  of 
Schreiber's  inoculation  of  a  boy  with  tuberculin.  The  al- 
leged quotation  begins :  "  I  am  sorry  to  say  that  it  is  very 
difficult  to  obtain  subjects  for  such  experiments.  There  are, 
of  colirse,  plenty  of  healthy  children  in  consumptive  fam- 
ilies, but  the  parents  are  not  always  willing  to  give  them 
up."  The  words,  "I  am  sorry  to  say  that,"  and  the  entire 
next  sentence,  "There  are,  of  course,  plenty  of  healthy 
children,"  etc.,  are  not  in  the  original,  hut  are  additions  made 
out  of  the  whole  cloth.  The  next  following  sentences  contain 
many  inacciu*acies,  such  as  the  translation  of  the  German 
words  betrdchtlich  anschwollen  as  "swelled  up  enormously," 
instead  of  "  swelled  up  considerably."  But  the  worst  is  the 
deliberate  insertion  of  the  following  sentence,  italicized  in 
the  pamphlet,  which  also  does  not  occur  in  the  original:  "I 
cannot  yet  say  whether  the  boy  will  be  consumptive  in  con- 
sequence of  my  treatment."  The  correct  translation  of 
Schreiber's  words  at  the  point  where  this  closing  sentence 
appears  in  the  pamphlet  is  as  follows:  "I  could  discover  no 
other  alterations  in  the  otherwise  apparently  healthy  boy." 
["Andere  Verdnderungen  honnte  ich  an  dem  sonst  gesund 
scheinenden  Knaben  nicht  entdeckenJ*] 

While  I  have  said  enough  about  this  case  to  substantiate 
my  charge  of  garbling  and  inaccuracy,  I  cannot  refrain  from 
utilizing  it  also  to  show  the  utter  misapprehension  which 
the  citation  of  detached  sentences  and  paragraphs  from 
medical  articles  is  calculated  to  create  in  the  mind  of  a  non- 
medical reader.  Even  when  the  words  are  quoted  correctly, 
they  are  likely,  when  detached  from  the  context,  to  give 
rise  to  entirely  false  impressions.  This  is  a  criticism  which 
applies  not  only  to  other  examples  cited  in  this  pamphlet, 
but  to  a  very  large  number  of  reports  of  experiments  and 
of  quotations  from  medical  journals  and  books  current  in 
antivivisectionist  writings,  and  the  resulting  dissemination 
of  erroneous  conceptions  is  often  greater  even  than  that 


AND  MEDICAL  PROGRESS  131 

caused  by  inaccurate  or  garbled  quotations.  A  brief  ex- 
planation of  the  present  example  will  show  the  justification 
of  this  charge. 

For  what  purpose  did  Professor  Schreiber  inoculate  the 
boy  with  tuberculin?  His  article  leaves  no  doubt  as  to  the 
answer.  He  points  out  the  importance  of  the  earliest  pos- 
sible recognition  of  tuberculosis  in  a  patient  in  order  to 
secure  the  best  curative  results.  The  boy's  mother  had 
consumption  and  the  author  calls  attention  to  the  fre- 
quency of  unrecognized  tuberculosis  in  the  offspring  of 
tuberculous  parents.  The  boy  received  a  small  dose  — :one 
milligram  —  of  tuberculin,  which,  if  he  were  free  from  tu- 
berculosis, would  produce  no  effect,  but  which,  if  he  had 
unsuspected  tuberculosis,  would  produce  a  transient — ■ 
though  possibly  a  severe  —  fever,  and  a  local  reaction 
indicative  of  tuberculosis.  Such  reaction  followed  the  in- 
jection of  tuberculin,  and  the  diagnosis  of  tuberculosis, 
which  had  not  been,  and  very  likely  could  not  have  been 
made  in  any  other  way,  was  established.  I  do  not  know 
what  could  have  been  more  fortunate  for  this  boy  than 
the  recognition  in  its  incipiency  of  a  disease  previously 
unsuspected  and  which,  recognized  thus  early,  should  in  all 
probability  be  cured  by  proper  treatment.  This  tuberculin 
test  is  constantly  employed  to  prevent  the  spread  of  tuber- 
culosis in  our  cattle.  In  our  children  it  enables  us  to  dis- 
cover the  same  disease  in  an  early,  curable  stage.  Shall  we 
care  for  our  cattle  better  than  for  our  children? 

The  use  of  tuberculin  is  not  properly  to  be  called  an 
"experiment"  at  all.  As  I  write  this,  I  find  in  the  "Jour- 
nal of  the  American  Medical  Association"  for  January  12, 
1901  (p.  75),  three  cases  of  the  use  of  tuberculin  in  human 
beings  by  Professor  J.  M.  Anders,  who  points  out  its  value 
in  enabling  us  to  diagnosticate  consumption  "in  latent 
forms  and  dubious  cases,  however  incipient,"  long  before 
percussion  or  the  stethoscope  will  reveal  the  disease.  I 
can  imagine  his  surprise  if  he  were  charged  with  making 


132  ANIMAL  EXPERIMENTATION 

three  horribly  cruel  "experiments"  and  injecting  the 
"  germs  of  consumption  " ! 

It  is  a  euphemism  to  call  such  an  alleged  quotation,  in 
which  words  and  one  entire  sentence  are  interpolated  and 
another  wholly  changed  in  meaning,  a  "mistranslation"  or 
even  a  "garbled  and  inaccurate"  account.  Does  it  not 
amount  to  literary  forgery?  It  is  another  illustration  of  the 
fact  that  when  an  antivivisectionist  attempts  to  say  any- 
thing about  scientific  experiments  either  the  moral  sense  is 
blunted  or  the  truth-telling  faculty  is  in  abeyance.  A  good 
English  example  are  the  misstatements  in  Miss  Frances 
Power  Cobbe*s  book,  laid  bare  by  Victor  Horsley,  and 
Schreiber's  and  Sanarelli*s  cases  will  serve  as  excellent  ex- 
amples of  American  misrepresentation  —  if  so  long  a  word 
is  needed  to  describe  them. 

I  am  sorry  my  reply  is  so  long,  but  in  fewer  words  I  could 
not  explain  the  many  and  gross  errors  to  be  pointed  out.  I 
have  given  you,  indeed,  "many"  instances  in  which  the 
references  are  "vague  and  inaccurate,"  and  "some"  in 
which  the  accounts  are  "garbled  and  inaccurate."  These 
adjectives  are,  I  submit,  very  mild  ones  to  apply  to  such  a 
pamphlet. 

You  can  hardly  be  surprised,  after  the  extraordinary  and 
repeated  interpolations,  mistranslations,  and  worse  which 
I  have  demonstrated  in  this  letter,  that  I  am  unwilling  to 
accept  any  alleged  quotation  or  translation  emanating 
from  the  American  Humane  Association  as  accurate  and 
truthful  unless  I  can  compare  it  with  the  source  from  which 
it  is  derived. 

In  conclusion,  let  me  commend  to  the  "Humane"  Asso- 
ciation the  closing  words  of  President  Eliot's  letter,  to  be 
y  found  on  pages  218-19  of  the  "Hearing":  "Any  attempt 
to  interfere  with  the  necessary  processes  of  medical  inves- 
tigation is,  in  my  judgment,  in  the  highest  degree  inex- 
_^    pedient  and  is  fimdamentally  inhuman." 

I  shall  take  the  liberty  of  publishing  my  reply.  I  suppose 


AND  MEDICAL  PROGRESS  133 

that  you  will  not  object  to  the  publication  of  your  letter 
with  it  in  order  to  explain  the  reason  for  the  reply. 
Very  respectfully  yours, 

William  W.  Keen. 

Addendum 

Since  this  letter  was  written  I  have  seen  an  article  in 
"Gould's  Year-Book  of  Medicine  and  Surgery,"  1901 
(Medical  volume,  p.  327),  from  the  "Archives  of  Pedi- 
atrics" for  June,  1900  (p.  431),  by  H.  Oliphant  Nicholson, 
of  Edinburgh,  Scotland,  reporting  the  case  of  Annie  C, 
a  girl  of  two  years  and  eight  months  old,  with  pictures, 
which,  with  a  brief  statement  of  the  case,  well  illustrates 
what  Dr.  Berkley  has  asserted,  that  "in  proper  cases,  the 
results  [of  the  treatment  by  thyroid  extract]  are  among 
the  most  resplendent  attained  by  modem  medicine,  con- 
verting the  drooling  dwarf  into  an  intelligent,  well-grown 
man  or  woman." 

This  child  was  first  seen  by  Dr.  Nicholson  on  October  23, 
1894,  and  the  picture  shows  the  "swollen,  myxedematous- 
looking  face  and  body,  a  markedly  curved  back,  and  a  pen- 
dulous abdomen."  The  child  "could  not  walk  without 
support  and  dragged  her  limbs  slowly  after  her."  Her  vo- 
cabulary was  confined  to  calling  her  mother  and  father 
"mum"  and  "ah,"  and  "her  wishes  were  wholly  made 
evident  by  signs."  Very  naturally,  therefore,  with  this 
low  grade  of  intelligence,  she  was  uncleanly  in  her 
hahits. 

The  treatment  was  begun  on  October  30,  with  2.5  grains 
of  thyroid  powder,  once  daily.  This  was  reduced  on  No- 
vember 2  to  1.25  grains  once  a  day,  and  was  continued  for 
several  weeks.  As  early  as  November  7,  improvement  was 
noticed.  On  November  17  the  pulse  at  the  wrist,  which  was 
scarcely  perceptible  through  the  swollen  tissues  at  the  be- 
ginning of  the  treatment,  was  distinctly  felt,  and  by  the 
24th,  the  puffiness  of  the  eyelids  and  forehead  were  dimin- 


134  ANIMAL  EXPERIMENTATION 

ishing  and  the  expression  of  the  face  becoming  more  intelli- 
gent. The  dose  of  the  extract  was  now  increased  again  to 
2.5  grains.  The  results  I  quote  as  follows :  — 

In  about  three  months'  time  very  few  traces  of  cretinism  re- 
mained and  the  child  was  able  to  walk  about  easily  without  assist- 
ance and  was  making  use  of  the  short  words  and  gestures  of  early 
childhood.  .  .  .  After  four  months  of  the  thyroid  treatment, 
the  improvement  seemed  so  complete  that  the  second  photograph 
was  taken  and  the  likeness  produced  is  that  of  a  bright,  happy, 
pretty  child,  to  all  appearances  normal,  both  physically  and  men- 
tally. The  improvement  continued  till  the  middle  of  June,  1895, 
when,  unfortunately,  she  contracted  an  attack  of  mahgnant 
measles  and  died  on  July  16,  after  three  days'  illness. 

If  Dr.  Berkley's  use  of  the  thyroid  extract,  which  cured 
two  out  of  eight  patients  was  an  experiment,  and  its  admin- 
istration by  Dr.  Nicholson  also  was  an  experiment,  the 
more  of  such  happy  "experiments"  we  could  have  the 
better. 

P.S.  (1914).  At  the  recent  Antivivisection  Congress 
in  Washington,  Mr.  E.  H.  Clement,  of  Boston,  stated 
categorically  (according  to  the  Washington  "Post,"  De- 
cember 9,  1913),  that  "Three  of  the  most  prominent 
physicians  in  Boston  —  Drs.  J.  Collins  Warren,  Richard 
C.  Cabot,  and  Maurice  H.  Richardson  —  have  assured 
me  personally  that  they  do  not  believe  in  vivisection." 

Now  I  knew  the  late  Dr.  Richardson  personally  and  in- 
timately ever  since  1886,  and  I  know  positively  that  this 
was  not  his  opinion,  and  both  Dr.  Warren  and  Dr.  Cabot 
assure  me  that  it  is  not  their  opinion. 


MISSTATEMENTS   OF  THE   ANTIVIVISEC- 
TIONISTS  AGAIN » 

San  Francisco,  July  8, 1901. 

On  January  21, 1901, 1  sent  a  reply  to  James  M.  Brown, 
president  of  the  American  Humane  Association,  in  response 
to  a  letter  from  him  challenging  me  to  produce  proof  of 
inaccuracy  in  the  references  to  a  number  of  certain  alleged 
experiments  and  of  garbling  of  the  reports  of  the  same.* 
My  reply  was  published  in  "The  Journal  of  the  American 
Medical  Association"  and  the  Philadelphia  "Medical 
Journal"  of  February  23,  1901. 

In  reply  I  received  a  letter  from  Mr.  Brown  saying  that  he 
expected  to  spend  the  month  of  February  in  California,  and 
could  not  give  attention  to  my  letter  until  his  return. 

Mr.  Brown  seems  to  have  been  detained  in  California 
much  longer  than  expected,  for  up  to  the  present  moment 
—  nearly  six  months  —  I  have  received  no  further  reply 
whatever  from  him.  Indirectly,  however,  a  certain  reply 
has  been  published  in  the  form  of  an  anonymous  pamphlet 
entitled  "The  Reality  of  Human  Vivisection,"  which  is 
called  a  "review"  of  my  letter. 

Not  long  since  I  had  the  pleasure  of  attending  a  lecture  to 
one  of  his  classes  in  moral  science  by  Rev.  Dr.  Faunce,  the 
accomplished  president  of  Brown  University.  Among  the 
virtues  which  he  discussed  was  "Courage,"  and  he  pointed 
out  the  moral  cowardice  of  anonymous  letters.  While  such 
a  letter  is  an  instance  of  private  moral  cowardice,  an  anony- 
mous pamphlet  such  as  this  is  an  instance  of  public  moral 
cowardice.   An  honorable  open  foe  I  at  least  respect;  one 

*  Reprinted  by  permission  from  the  Journal  of  the  American  Medical 
Association  for  August  16,  1901. 
2  Ante,  p.  110. 


136  ANIMAL  EXPERIMENTATION 

who  skulks  behind  anonymous  pamphlets  I  despise.  The 
antivivisectionists  seem  to  deHght  in  such  secrecy  and 
anonymous  attack. 

There  are  four  publications  on  this  subject  up  to  the 
present  moment,  to  which  I  shall  hereafter  refer  by  num- 
ber, except  the  last,  which  I  shall  call  the  "review." 

1.  In  Senate  Document  No.  78,  55th  Congress,  3d  Ses- 
sion, the  last  of  a  collection  of  certain  antivivisectionist 
papers  is  one  entitled  "Human  Vivisection,"  signed  "A. 
Tracy."   I  should  like  to  know  who  this  mysterious  "A. 
Tracy"  is.  1 

2.  There  is  a  pamphlet  entitled  "Human  Vivisection," 
third  edition,  printed  for  the  American  Humane  Associa- 
tion in  1900,  which  reprints  this  paper  (with  the  omission 
of  "A.  Tracy's"  name)  and  adds  to  it  a  long  continuation 
of  the  misstatements  of  the  first.  This  is  anonymous. 

3.  There  is  a  small  pamphlet  entitled  "Human  Vivisec- 
tion," published  by  the  Humane  Society,  Washington, 
D.C.,  chiefly  a  rehash  of  the  misstatements  of  pamphlet 
No.  2.  This  is  also  without  the  name  of  any  author. 

4.  Now  comes  the  last  pamphlet,  the  "review"  of  my 
letter.  This  is  not  only  without  the  name  of  any  author, 
but  without  even  that  of  a  publisher.  It  is  simply  dated 
"Boston,  1901." 

The  character  of  every  one  of  these  publications,  however, 
is  such  that  I  do  not  wonder  that  the  author  wishes  to  con- 
ceal his  identity. 

The  "review"  (No.  4)  reprints  Mr.  Brown's  letter  to  me, 
and  at  the  end  adds:  "No  suiBficient  rejoinder  to  his  [my] 
letter  [in  reply  to  Mr.  Brown]  would  be  admitted  to  the 
columns  of  these  medical  periodicals  "  ("The  Journal  of  the 
American  Medical  Association"  and  the  Philadelphia 
** Medical  Journal").  The  duplicity  of  this  sentence  is  evi- 
dent. The  ordinary  reader,  for  whom  it  is  evidently  in- 
tended, would  understand  that  a  reply  had  been  sent  to  the 
^  See  footnote,  ante,  p,  115. 


AND  MEDICAL  PROGRESS  137 

editors  of  these  medical  journals  and  that  they  had  declined 
to  print  it.  This  is  absolutely  untrue.  No  such  communica- 
tion has  ever  been  received  by  the  editor  of  either  of  these 
journals.  The  critical  reader  will  see  that  the  sentence  just 
quoted  does  not  definitely  state  that  such  a  communication 
has  been  rejected.  But  for  one  critical  reader  a  thousand 
casual  readers  will  get  the  impression  which  the  sentence 
was  evidently  intended  to  convey. 

It  is  impossible  for  me  to  take  up  all  the  misstatements 
and  misrepresentations  contained  in  the  thirty-two  pages 
of  this  last  anonymous  "review,"  nor  is  it  necessary  to  do 
so.  That  I  should  be  honored  from  such  a  source  by  vilifi- 
cation and  misrepresentation,  I  expected,  of  course,  but  I 
did  hope  at  least  that  there  would  be  an  honesty  of  state- 
ment to  which  no  exception  could  be  taken. 

The  author,  however,  is  a  very  curious  person  who  does 
not  seem  to  be  limited  by  the  ordinary  laws  of  either  fair 
dealing  or  truthful  statement. 

Moreover,  he  would  be  a  very  poor  lawyer.  Most  of  the 
evidence  cited  by  him  is  derived  from  published  reports  by 
certain  medical  men.  Having,  therefore,  chosen  his  wit- 
nesses and  put  them  on  the  stand,  he  would  not  be  allowed 
in  any  court  of  law  to  discredit  his  own  witnesses  by  select- 
ing part  of  their  testimony  as  trustworthy  and  rejecting 
part  as  unworthy  of  credence.  And  yet,  throughout  this 
"review,"  while  the  anonymous  author  is  eager  to  accept 
the  statements  of  the  various  authorities  as  to  what  they 
did,  he  declines  to  admit  their  statements  as  to  their  results, 
or  else  misstates  them,  going  so  far  as  to  assert  that  the 
statements  of  the  physicians  cited,  concerning  the  recovery 
of  their  patients,  are  "utterly  valueless." 

In  my  reply  to  Mr.  Brown,  I  used  the  following  language: 
"Let  me  again  state  clearly  the  question  at  issue.  It  is  not 
whether  the  experiments  meet  with  my  approval,  but  solely 
whether  the  reports  of  them  in  the  pamphlet  issued  by  the 
American  Humane  Association  are  reliable  and  accurate 


138  ANIMAL  EXPERIMENTATION 

both  as  to  their  sources  and  substance."  At  the  hearing 
before  the  Senate  committee,  I  distinctly  twice  over  ex- 
pressed my  utter  disapproval  of  many  of  the  experiments 
referred  to  in  the  original  pamphlet  (No.  2).  This  con- 
demnation is  quoted  both  on  page  1  and  page  5  of  the 
anonymous  "review";  yet,  in  spite  of  these  two  statements 
and  the  third  in  my  letter  to  Mr.  Brown,  just  quoted,  the 
author  represents  me  throughout  his  "review"  as  the 
apologizer  and  the  advocate  of  such  experiments,  thus 
publishing,  yet  at  the  same  time  willfully  ignoring,  my 
repeated  statements  to  the  contrary. 

In  my  letter  to  Mr.  Brown,  in  support  of  my  accusation 
that  many  of  the  references  in  the  pamphlet  on  "Human 
Vivisection"  are  "vague  and  indefinite,"  I  cited  fourteen 
instances  of  quotations  from  newspapers,  five  of  which  were 
without  date,  and  I  added  six  other  instances  of  "vague  and 
indefinite"  references  not  to  newspapers.  I  commented 
upon  the  unreliability  of  newspapers  as  a  source  of  author- 
ity in  medical  matters. 

Let  us  see  how  the  anonymous  reviewer  attempts  to  meet 
this  issue.  The  facts  he  does  not  and  cannot  deny.  In  the 
first  place,  he  claims  that  I  have  changed  the  issue  from 
"the  question  of  *  vague  and  indefinite  quotation'  to  that 
of  vague  and  indefinite  *  references.' "  When  I  stated  at  the 
Senate  hearing  (stenographer's  report),  "Many  of  them 
are  so  vague  and  indefinite  that  I  could  not  look  them  up," 
it  must  have  been  clear  to  any  one  of  common  sense  that  I 
referred  to  the  references  to  the  experiments,  and  there  was 
no  misunderstanding  on  this  point  in  the  letter  of  Mr. 
Brown,  who  asks,  "To  what  other  of  the  references  above 
given  did  you  refer  when  you  informed  the  Senate  commit- 
tee that  *many  of  them  were  so  vague  and  indefinite  that  1 
could  not  look  them  up'?"  1  was  challenged  by  Mr.  Brown 
to  adduce  examples  of  "vague  and  indefinite  references," 
and  this  challenge  I  successfully  met. 

On  page  22,  the  anonymous  reviewer  says:  "Of  the  four- 


AND  MEDICAL  PROGRESS  139 

teen  journals  referred  to,  every  one  conveying  a  statement 
of  fact  —  save  one  —  had  its  name  and  date  of  publication 
plainly  given."  Here  it  will  be  observed  that  a  distinction 
is  drawn  between  references  to  articles  "conveying  a  state- 
ment of  fact,"  and  those  which  do  not  relate  to  statements 
of  fact.  My  indictment  against  the  pamphlet  on  "Human 
Vivisection  "  (No.  9)  was  and  is  that  many  of  the  references 
are  so  "vague  and  indefinite"  that  the  original  sources  of 
alleged  quotations  cannot  be  consulted,  and  that  some  of 
the  reports  are  "garbled  and  inaccurate."  It  may  be  just 
as  important  to  determine  the  accuracy  of  a  reference  to  an 
expression  of  an  opinion  as  to  learn  the  facts  upon  which 
the  opinion  is  supposed  to  be  based,  and  to  charge  me  with 
an  evasion  of  the  issue  because  I  did  not  restrict  myself 
solely  to  one  particular  class  of  references,  but  pointed  out 
the  vague  and  indefinite  character  of  all  classes  of  refer- 
ences in  the  pamphlet,  is  too  absurd  to  require  further 
comment. 

As  a  matter  of  fact,  as  pointed  out  in  my  letter  to  Mr. 
Brown,  there  are  no  less  than  five  citations  or  reports  of 
experiments  in  pamphlet  No.  2  for  which  either  no  refer- 
ence whatever  is  given,  or  the  one  inserted  is  wrong  or  so 
vague  and  indefinite  that  the  original  cannot  be  consulted. 

On  page  9,  the  anonymous  reviewer  says:  "It  was 
pointed  out  by  the  president  of  the  American  Humane  As- 
sociation that,  with  one  exception,  every  phase  of  experi- 
mentation specifically  mentioned  had  some  reference  to  a 
medical  authority."  It  is  incredible  that  the  reviewer 
should  not  have  known  the  falsity  of  the  statement  attri- 
buted by  him  to  the  president  of  the  American  Humane 
Association,  or  he  may  think  that  in  this  strangely  worded 
sentence  he  has  constructed  some  loophole  of  escape 
through  such  avenues  as  may  be  afforded  by  throwing  the 
responsibility  for  a  false  statement  upon  another,  or  by 
such  equivocal  phrases  as  "every  phase  of  experimenta- 
tion," "specifically  mentioned,"  "some  reference."  There 


140  ANIMAL  EXPERIMENTATION 

are,  in  fact,  in  the  pamphlet  of  the  American  Humane 
Association  seven  instances  in  which  reference  to  a  medical 
authority  for  the  experiments  mentioned  is  lacking,  and  in 
addition  the  sole  authority  for  an  important  part  of  the 
statements  regarding  Sanarelli's  experiments  are  the  corre- 
spondent of  a  daily  newspaper  and  a  speaker  at  a  conven- 
tion of  the  American  Humane  Association. 

Let  us  see  how  the  reviewer  tries  to  meet  my  demonstra- 
tion of  numerous  instances  of  "garbled  and  inaccurate" 
quotations  in  pamphlet  No.  2.  Here  again  the  facts  cannot 
be  denied,  but  an  attempt  is  made  to  minimize  their 
importance. 

1.  "Brevity  of  quotation  is  often  absolutely  necessary" 
("review,"  p.  9).  Why,  then,  as  I  pointed  out  in  my  letter, 
are  whole  sentences  added  which  do  not  appear  at  all  in  the 
original? 

2.  Errors  are  described  in  the  "review"  as  a  "transla- 
tor's exaggeration"  (p.  6),  "blunders  of  a  copyist"  (p.  6), 
** errors  of  a  translator  "  (p.  7) .  So,  then,  it  is  now  conceded 
that  the  pamphlet  does  contain  "exaggerations,"  "blun- 
ders," and  "errors."  It  contains  not  merely  "errors  of  a 
translator,"  but  deliberate  falsification  and  misrepresenta- 
tions. When  a  translator  says  what  the  author  did  not  say; 
when  the  word  "collapse"  is  translated  "final  collapse," 
and  an  oration  is  made  upon  the  death  of  patients  who  did 
not  die;  when  the  American  Humane  Association  in  refer- 
ence to  these  very  cases  quotes  on  the  cover  of  its  pamph- 
let, "Is  scientific  murder  a  pardonable  crime?"  in  spite  of 
the  published  fact  that  the  patients  referred  to  did  not  die; 
when  the  translator  again  and  again  interpolates  words, 
phrases,  and  sentences  which  do  not  exist  in  the  original; 
when  essential  phrases  and  paragraphs  are  omitted,  — 
these  I  submit  are  not  the  mere  "errors  of  a  translator," 
but  deliberate  misrepresentations.  Instances  of  all  of  these 
I  furnished  Mr.  Brown  in  reply  to  his  challenge. 

The  pamphlet,  moreover,  contains,  as  I  have  pointed 


AND  MEDICAL  PROGRESS  141 

out,  false  or  misleading  quotations  which  could  not  be 
attributed  to  "errors  of  a  translator,"  as  they  were  from 
English  sources.  One  can  only  hope  that  hereafter  the 
"translators'*  and  "copyists"  employed  by  the  antivivi- 
sectionists  may  be  more  accurate,  or  rather  that  the  men 
and  women  back  of  these  poor  employees  may  be  willing 
not  to  distort  and  suppress  the  truth  in  order  to  effect  their 
purpose.  It  is  a  safe  rule,  I  repeat,  not  to  believe  any  state- 
ment of  an  antivivisectionist  until  its  accuracy  is  estab- 
lished by  reference  to  the  original  source  from  which  the 
alleged  statement  or  quotation  is  derived. 

3.  My  charge  of  garbling  and  inaccuracy  of  quotation  is 
practically  admitted,  but  the  reviewer  states  (p.  15) :  "For 
none  of  them  [the  translations]  was  the  American  Humane 
Association  responsible  in  any  way  whatever."  It  is  now 
rather  late  in  the  day  to  advance  this  disclaimer,  after  the 
insertion  on  the  inside  of  the  cover  of  the  pamphlet  of  the 
sentence,  "The  facts  are  indisputable,"  and  in  the  preface, 
over  the  signature  of  the  president  and  secretary  of  the 
Association,  the  words,  "In  each  case,  the  authority  is 
given."  It  is  a  favorite  trick  of  antivivisectionists  to  at- 
tempt to  throw  off  in  this  way  responsibility  when  con- 
fronted with  incontrovertible  evidence  of  false  statements, 
as  is  illustrated  in  the  controversy  between  Miss  Cobbe  and 
Mr.  Horsley. 

I  shall  be  curious  to  see  the  fourth  edition  of  this  pamph- 
let. For  it  I  now  furnish  one  more  instance  of  false  state- 
ment, the  evidence  of  which  was  not  in  my  possession  last 
January.  Even  Mr.  Brown  admits  that  to  this  "the  refer- 
ence may,  perhaps,  be  called  indejQnite."  I  submit  that 
"perhaps"  it  may,  for  no  book,  journal,  or  any  other  publi- 
cation was  named.  The  instance  I  refer  to  is  Jansen's  lec- 
ture purporting  to  be  quoted  on  page  26  of  pamphlet  No.  2. 
The  lecture  was  published,  I  have  since  found,  in  a  well- 
known  journal,  the  "  Centralblatt  f .  Bakteriologie  u.  Par- 
asitenkunde"  (1891,  vol.  x,  p.  40).  So  gross  is  the  falsifica- 


142  ANIMAL  EXPERIMENTATION 

tion  that  the  reference  was  "perhaps"  wisely  omitted.  The 
first  phrase  of  the  quotation  is  as  follows,  "When  I  began 
my  experiments  with  smallpox  pus,'*  etc.  This  is  an  ab- 
solute untruth.  What  Jansen  used  was  not  smallpox  pus 
at  all,  but  sterilized,  diluted  vaccine  lymph,  and  sterilized 
blood  serum  from  vaccinated  calves,  which  could  do  no 
more  harm  than  injecting  so  much  water.  The  entire 
extract  is  inaccurate  as  a  translation.  There  can  be  no 
question  but  that  the  substitution  in  this  alleged  quota- 
tion of  "smallpox  pus"  for  "sterilized  vaccine  lymph" 
cannot  be  attributed  to  the  mere  "error  of  a  translator," 
but  is  a  deliberate  falsification,  and  this  in  a  pamphlet  in- 
troduced with  the  statement  to  the  reader,  "The  facts  are 
indisputable"! 

Much  has  been  made  of  my  statement  that  I  could  only 
find  in  the  pamphlet  references  to  "two  experiments"  in 
America.  My  reason  for  this  statement  was  very  simple 
and  perfectly  evident  to  any  honest-minded  reader. 

In  the  pamphlet  "Human  Vivisection"  (No.  2)  there  are 
a  number  of  experiments  related,  the  numbered  ones  begin- 
ning with  the  following  on  page  4:  "  1.  Vivisection  Experi- 
ments upon  the  Insane."  Under  this  title  several  experi- 
ments, all  of  the  same  nature  and  by  the  same  individual, 
are  reported,  eight  being  referred  to  in  all.  On  page  5, 
appears,  "2.  Vivisection  of  Children  in  Boston";  and 
under  this  a  number  of  experiments,  all  by  the  same  person, 
are  referred  to.  Anybody  with  common  sense  would  see 
that  when  I  referred  to  "two"  instances,  I  did  not  mean 
two  individual  experiments,  but  using  the  classification  of 
their  own  pamphlet,  I  referred  to  Nos.  "1"  and  "2"  on 
pages  4  and  5.  In  fact,  I  specifically  referred  to  these  pages 
and  mentioned  various  experiments  under  each  caption. 

I  presume,  however,  that  it  is  useless  to  expect  fairness 
from  an  ambushed  enemy. 

The  anonymous  "reviewer's"  suggestion  that  as  I  was 
president  of  the  American  Medical  Association  last  year, 


AND  MEDICAL  PROGRESS  143 

therefore  I  am  responsible  for  every  paper  read  before  that 
body,  —  when  there  were  hundreds  of  papers  read  in  over  a 
dozen  sections  before  several  thousand  members,  —  is  so 
amusing  that  I  pass  it  by  with  a  smile  at  the  author's 
simplicity. 

One  sentence  of  my  letter  I  wrote  perhaps  better  than  I 
knew.  In  the  account  of  Sanarelli's  experiments  a  certain 
sentence,  "I  have  seen  unrolled  before  my  eyes,"  etc.  was 
quoted  by  "A.  Tracy"  in  the  original  paper  (No.  1).  In 
that  pamphlet  two  references  were  given,  one  to  the  "Brit- 
ish Medical  Journal,"  the  other  to  the  "New  England  Med- 
ical Monthly."  I  stated  that  this  entire  sentence  occurred 
in  neither  of  these  journals  and  I  added:  "Whether  it  is 
quoted  from  some  other  source  not  indicated  or  has  been 
deliberately  added,  I  leave  you  or  A.  Tracy  to  explain." 
The  "reviewer"  explains  that  this  quotation  was  from 
another  source  not  indicated  (surely  this  was  "vague  and 
indefinite"),  namely,  Sanarelli's  original  Italian  paper, 
though  no  reference  to  it  was  given. 

Inasmuch  as  in  my  letter  to  Mr.  Brown  I  gave  the  refer- 
ence to  Sanarelli's  original  paper,  the  anonymous  author  of 
the  "review"  pays  me  the  compliment  of  supposing  that  I 
am  a  facile  Italian  scholar,  and,  therefore,  that  I  was  per- 
fectly aware  that  Sanarelli  himself  wrote  this  sentence. 
"With  the  volume  in  his  hands,  the  original  article  open 
before  his  eyes,"  says  the  "reviewer,"  "would  he  have  us 
believe  that  he  did  not  take  the  trouble  to  compare  and 
verify  the  only  quotation  from  it  which  appears  in  the  pam- 
phlet? He  did  not  see  it?  Credat  Judaeus  Apella!  There 
are  limitations  to  credulity.  But  how  queer  must  be  that 
sense  of  honor  which  would  permit  a  man  to  make  a  dis- 
graceful imputation  knowing  all  the  while  that  every  word 
of  it  was  false!" 

The  simple  facts  of  the  case  are  these.  Unfortunately,  I 
am  not  an  Italian  scholar,  and  have  never  even  seen  Sana- 
relli's original  article.  In  order  to  find  out  the  real  fact,  I 


144  ANIMAL  EXPERIMENTATION 

wrote  to  a  friend  who  reads  Italian  well,  to  learn  whether 
these  G.ve  patients  really  died,  as  the  American  Humane 
Association  pamphlet  (No.  2)  asserted.  He  replied  giving 
me  the  original  reference,  and  stated  that  not  one  of  them 
died. 

As  the  "reviewer"  points  out  that  this  quotation  by  "A. 
Tracy"  was  from  SanarelU*s  original  paper,  a  very  interest- 
ing inquiry  arises,  namely,  if  "A.  Tracy"  in  Senate  Docu- 
ment No.  78,  as  is  now  claimed,  quoted  from  this  original 
paper  of  Sanarelli,  it  is  in  order  for  him  now  to  explain  how 
it  is,  when  Sanarelli's  original  paper  states  that  all  of  these 
patients  recovered,  that  he  states  that  some,  if  not  all  of 
them  died,  and  how  he  dares  to  quote  nearly  a  page  of  ora- 
tory about  "scientific  murder"  and  "assassination,"  based 
upon  this  false  statement. 

On  page  26  of  the  anonymous  "review"  the  author  dis- 
putes the  value  of  tubercuKn  as  a  test  for  incipient  con- 
sumption in  children.  Were  it  worth  my  while  I  could  give 
him  references  to  disprove  this  statement,  but  in  view  of 
his  amazing  ignorance  of  modern  medical  progress,  as 
evinced  by  the  next  statement,  I  do  not  propose  to  take 
the  trouble.  He  says,  "Dr.  Keen  knows  perfectly  well,  in 
the  first  place,  that  phthisis,  however  early  discovered,  is  not 
in  all  probability  a  curable  ailment."  Has  he  never  made  a 
post-mortem  examination  and  found  a  cured  phthisis?  Has 
he  never  visited,  or  even  read  of,  the  Adirondacks,  or  Den- 
ver, or  Colorado  Springs,  or  Minnesota,  or  Arizona,  or  New 
Mexico,  or  a  score  of  other  such  places?  Has  he  never  read 
of  the  many  books  and  pamphlets  on  sanatoria  for  con- 
sumptives? Does  he  know  nothing  of  these  modern  move- 
ments? Koch's  discovery  of  the  bacillus  of  tuberculosis  by 
experiment  upon  animals  in  1882  has  done  more  to  help  in 
curing  consumption  and  other  forms  of  tuberculosis  than 
any  other  one  means  and  especially  by  early  recognition  of 
the  disease.  If  he  will  consult  the  recent  prize  essay  on 
"Tuberculosis  as  a  Disease  of  the  Masses  and  how  to  Com- 


AND  MEDICAL  PROGRESS  145 

bat  it,"  by  Dr.  S.  A.  Knopf,  of  New  York,  he  will  be  made 
aware  of  the  facts.  This  essay  was  awarded  the  prize  by  the 
International  Tuberculosis  Congress  last  year  in  Berlin  in 
a  competition  in  which  eighty-five  prize  essays  were  pre- 
sented from  all  over  the  world. 

When  I  see  the  statement  that  phthisis  is  not  curable 
even  when  discovered  at  an  early  stage,  put  forth  seriously 
by  my  anonymous  reviewer,  I  throw  down  the  pamphlet  in 
despair.  One  cannot  argue  further  with  such  dense  ignor- 
ance. It  is  equal  only  to  the  assertion  of  another  medical 
light  among  the  antivivisectionists,  that  brain  tumors 
cannot  be  located  outside  the  motor  area. 


MIDSHIPMAN  AIKEN  AND  VIVISECTION  ^ 

An  Open  Letter  to  Hon.  Jacob  H.  Gallingery  Chairman  of 
the  Senate  Committee  for  the  District  of  Columbia, 
Washington,  D.C. 

My  Dear  Sir,  —  As  you  have  repeatedly  introduced 
bills  into  the  Senate  for  the  purpose  nominally  of  regulating 
experiments  upon  animals  in  the  District  of  Columbia, 
which  bills,  however,  if  they  had  become  laws,  would  in 
fact  have  prohibited  many,  if  not  all,  of  them,  I  deem  it  my 
duty  to  call  your  attention  to  the  case  of  Midshipman 
Aiken,  of  the  United  States  Naval  Academy,  who  was 
recently  injured  in  a  football  game.^  My  reason  for  doing 
so  is  to  show  you  by  a  single  concrete  example  that  knowl- 
edge gained  by  animal  experimentation  is  an  immense  boon 
to  humanity  and  that,  therefore,  such  experiments  should 
be  heartily  encouraged. 

The  facts  of  Mr.  Aiken's  case  are  as  follows:  When  I 
first  saw  him,  three  days  after  the  accident,  I  found  that 
he  had  been  unconscious  for  a  half -hour  after  the  accident 
and  ever  since  then  had  complained  bitterly  of  headache, 
which  he  located  always  in  the  forehead.  Mentally  he  was 
very  dull,  though  not  comatose.  His  pulse  was  slowed 
down  to  52  instead  of  being  72,  the  normal.  Soon  after  the 
accident  he  began  to  develop  convulsions,  first  in  the 
right  leg,  afterward  in  the  right  arm  also,  the  right  arm 
being  finally  the  chief  seat  of  the  convulsions.  When  they 
were  very  severe  they  involved  the  left  side  also.  The  face 
was  never  involved.  In  six  and  one  half  hours  after  I  first 

*  Reprinted  from  the  Philadelphia  Medical  Journal,  December  13, 
1902. 

2  The  facts  had  been  already  obtained  without  my  knowledge  by  the 
reporters  and  published  in  the  daily  newspapers;  hence  I  felt  at  liberty  to 
describe  the  case  publicly. 


MEDICAL  PROGRESS  147 

saw  him  he  had  twenty-four  of  these  attacks,  all  limited  to 
the  right  arm.  They  were  not  attended  with  any  loss  of 
consciousness.  They  exhausted  him  very  greatly,  especially 
when  they  were  excessively  severe.  Several  times  it  was 
necessary  to  give  him  chloroform. 

There  was  no  fracture  of  the  skull.  The  only  physical 
evidence  of  any  injury  was  a  very  shght  bruise  at  the  outer 
end  of  the  left  eyebrow. 

Had  I  seen  this  case  before  1885,  I  should  have  been 
unable  to  explain  why  the  spasms  were  chiefly  manifested 
in  the  right  arm,  and  from  the  evidence  of  the  slow  pulse, 
the  headache,  the  stupor,  the  bruise  in  the  left  temple, 
etc.,  I  should  have  been  justified  in  inferring  that  probably 
the  front  part  of  the  brain  was  injured  at  the  site  of  the 
bruise.  Had  I  opened  his  skull  at  that  point,  I  should  have 
found  a  perfectly  normal  brain  and  should  have  missed  the 
clot.  The  young  man,  therefore,  would  have  died  whether 
his  skull  had  been  opened  or  not. 

In  1902,  observe  the  difference.  As  a  result  of  the  knowl- 
edge derived  from  experiments  upon  animals  which  have 
located  precisely  the  center  for  motion  of  the  right  arm  on 
the  left  side  of  the  brain  near  the  top  and  a  little  in  front 
of  a  vertical  line  drawn  through  the  ear,  and  disregarding 
entirely  the  site  of  the  headache  and  the  bruise,  I  reached 
the  conclusion  that  there  had  been  a  rupture  of  a  blood- 
vessel within  the  head,  which  had  poured  out  a  quantity 
of  blood,  and  that  the  situation  of  the  clot  should  corre- 
spond to  the  "arm  center."  The  location  of  this  arm  cen- 
ter was  far  away  (about  three  inches)  from  the  location  of 
the  bruise,  and  its  position  was  fixed  absolutely  as  a  result 
of  experiments  upon  animals,  confirmed  later  by  many 
operations  on  human  beings  and  also  by  post  mortems. 
The  operation  was  done  on  November  19,  1902. 

As  soon  as  the  skull  was  opened  at  this  point,  the  clot 
was  found,  its  thickest  point  being  exactly  over  the  arm 
center,  and  nine  tablespoonfuls  of  blood  were  removed. 


148  ANIMAL  EXPERIMENTATION 

with  the  result  that  the  patient's  life  has  been  saved.  The 
blood  had  first  been  poured  out  over  the  "leg  center," 
which  is  located  a  little  higher  up  than  that  for  the  arm. 
This  explained  the  early  spasms  in  the  right  leg.  The  clot 
did  not  extend,  however,  further  down  than  the  arm  center. 
This  explained  why  the  face  was  never  convulsed,  for 
the  "face  center"  lies  just  below  that  for  the  arm.  [See 
Fig.  1,  p.  48.] 

I  think  if  you  were  to  ask  the  parents  of  this  young  man 
how  many  animals  they  would  be  willing  to  have  sacrificed 
in  order  that  their  son  might  have  his  life  saved,  there 
would  be  no  doubt  of  the  answer.  Indeed,  had  it  been  your 
own  son,  I  cannot  doubt  the  answer.  But  this  is  only  one 
of  hundreds  of  cases  in  which  a  similar  exact  localization 
has  been  made  by  many  surgeons,  both  in  Europe  and 
America.  Yet,  by  a  curious  coincidence,  in  the  very  same 
issue  of  a  Baltimore  newspaper  containing  a  reporter's 
account  of  the  successful  operation  on  Midshipman  Aiken, 
there  is  a  letter  signed  by  an  active  antivivisectionist  agita- 
tor, which,  among  other  misstatements  and  misrepresenta- 
tions usually  found  in  such  publications,  asserts  that 
"brain  surgery  is  disregarded." 

If  the  laws  which  you  and  your  friends  advocate  were  in 
force,  the  conditions  for  scientific  investigation  in  medicine 
in  this  country  would  be  quite  as  deplorable  as  those  in 
England.  For  example,  when  Lord  Lister,  who  has  revolu- 
tionized modern  surgery,  largely  as  a  result  of  such  experi- 
ments, wished  to  discover  possibly  some  still  better  way 
of  operating  by  further  experiments,  he  was  obliged  to  go 
to  Toulouse  to  carry  them  out,  as  the  vexatious  restrictions 
of  the  law  in  England  practically  made  it  impossible  for 
him  to  continue  there  these  preeminently  humane  experi- 
ments. 

Again,  when  Sir  T.  Lauder  Brunton,  in  London,  started 
a  series  of  experiments  on  animals  to  discover  an  antidote 
for  the  cobra  and  other  snake  poisons  of  India,  where  every 


AND  MEDICAL  PROGRESS  149 

year  twenty  thousand  human  lives  are  sacrificed  by  snake 
bites,  these  beneficent  researches  were  stopped  by  the 
stringent  British  laws  to  protect  animals.  Meanwhile  half 
a  million  of  human  beings  have  perished. 

Who,  I  may  ask,  is  the  more  humane;  he  who,  doubtless 
with  the  best  and  sincerest  motives  of  love  for  dumb 
beasts,  would  prohibit  experiments  upon  animals  and 
thereby  prevent  the  acquisition  of  such  knowledge  and  so 
compel  surgeons  to  stand  with  folded  arms  and  see  in- 
numerable lives  thus  needlessly  sacrificed;  or  he  who,  by 
properly  instituted  experiments,  would  discover  such  new 
truths  and  apply  them  to  the  service  of  humanity? 

The  antivivisectionists  have  frequently  denied  that  sur- 
geons have  learned  anything  from  such  experiments.  I 
presume  that  I  may  be  considered  a  competent  witness  as 
to  the  source  at  least  of  my  own  knowledge,  and  I  state 
with  the  greatest  positiveness  that,  without  the  knowledge 
derived  from  experiments  upon  animals  which  have  demon- 
strated the  facts  of  cerebral  localization,  I  should  never 
have  been  able  to  locate  the  clot  in  Mr.  Aiken's  head  and  to 
remove  it,  nor  should  I  have  been  able  in  the  last  fifteen 
years  to  locate  numerous  tumors  and  other  brain  troubles 
and  relieve  many  of  them.  What  is  true  of  myself  is 
equally  true  of  other  surgeons. 

In  view,  therefore,  of  the  evident  and  positive  benefit  of 
such  experiments,  I  trust  that  you  will  be  wilhng  to  desist 
from  further  efforts  at  such  repressive  and,  as  I  regard  it, 
most  inhumane  and  cruel  legislation. 

As  this  matter  is  of  vital  importance  to  the  well-being  of 
the  entire  community,  I  shall  take  the  liberty  of  giving  this 
letter  to  the  press  as  soon  as  you  have  received  it. 
Very  respectfully  yours, 

W.  W.  Keen. 

[This  fine  young  man's  later  history  is  of  great  interest. 
In  spite  of  my  injunctions  to  drop  back  one  year  in  the 


150  ANIMAL  EXPERIMENTATION 

Naval  Academy  he  studied  extra  hard,  made  up  all  his  lost 
time,  graduated  with  his  class,  and  entered  the  navy. 

On  January  10, 1909,  over  six  years  after  the  accident,  he 
was  examined  for  life  insurance  and  was  passed  as  "a  first- 
class  risk'*  and  the  policy  was  issued. 

Six  months  later,  July  11,  1909,  he  was  killed  by  an 
explosion  in  a  coal  bunker  on  his  ship,  the  North  Carolina, 
lying  in  the  harbor  of  Naples.  He  gallantly  refused  to  let 
his  men  enter  the  bunker,  where  there  was  supposed  to  be  a 
fire,  until  he  had  explored  it  himself.  He  saved  their  lives  at 
the  expense  of  his  own.] 


RECENT  SURGICAL  PROGRESS  A  RESULT 
CHIEFLY  OF  EXPERIMENTAL  RESEARCH  * 

In  October,  1889,  and  June,  1893,  in  "Harper's  Maga- 
zine," I  gave  some  account  of  the  progress  of  surgery.  In 
the  sixteen  years  that  have  elapsed  since  my  last  paper  was 
written  there  has  been  much  further  progress  in  various 
directions.  I  can  only  consider  a  very  few  of  these  advances, 
and  even  those  in  a  very  incomplete  manner. 

Surgery  of  the  Heart 

Up  to  the  publication  of  Fischer's  paper  in  1867,  scarcely 
any  surgeon  took  the  surgery  of  the  heart  seriously.  That 
paper  was  based  on  a  study  of  four  hundred  and  fifty-two 
published  cases  of  wounds  of  the  human  heart,  and  he 
showed  that  a  patient  might  live  for  hours  or  even  days 
with  a  wounded  heart. 

In  1881,  Dr.  John  B.  Roberts,  of  Philadelphia,  made  the 
bold  proposal  dehberately  to  sew  up  a  wound  of  the  heart, 
in  spite  of  the  fact  that  Billroth,  the  then  most  distin- 
guished Continental  surgeon,  had  declared  that  no  one  who 
wished  to  preserve  the  respect  of  his  colleagues  would  ever 
attempt  to  operate  on  the  heart.  In  1896,  after  a  number  of 
experiments  upon  animals,  two  unsuccessful  attempts  to 
sew  up  a  wound  of  the  heart  were  pubHshed,  followed  hap- 
pily in  1897  by  Rehn's  famous  paper  recording  the  first 
successful  case.  How  quickly  surgeons  followed  this  happy 
lead  is  seen  by  the  statistics  given  me  by  Dr.  Francis  T. 
Stewart  (who  himseK  has  had  a  successfid  case),  that  up  to 
June,  1908,  one  hundred  and  forty-one  cases  of  wound  of 
the  heart  had  been  operated  on,  and  sixty-four  of  them  had 

*  Reprinted  by  the  kind  permission  of  Harper  &  Bros,  from  Haryer^s 
Magazine  for  April,  1909. 


152  ANIMAL  EXPERIMENTATION 

recovered.  When  one  considers  the  difficulties  of  such  an 
operation,  —  the  speed  with  which  the  heart  must  be  ex- 
posed by  making  a  trap-door  through  the  chest  wall,  then 
dividing  two  or  three  ribs,  without,  if  possible,  injuring  the 
left  lung,  opening  the  sac  in  which  the  heart  lies  (the  peri- 
cardium), clearing  it  of  blood,  seizing  the  heart,  and  while 
it  is  actively  pulsating,  with  a  jet  of  blood  from  the  wound 
at  every  pulsation  obscuring  the  field  of  operation  —  when 
one  considers  these  difficulties,  and  yet  notes  that  over 
forty-five  per  cent  have  recovered,  and  that  this  percentage 
of  recoveries  is  steadily  increasing,  it  is  a  matter  of  both 
surprise  and  gratification. 

In  a  good  many  operations,  when  chloroform  and  even 
sometimes  when  ether  is  given,  the  patient  suddenly 
passes  into  collapse,  the  heart  ceases  to  beat,  the  respira- 
tion stops  a  few  minutes  afterward,  and  death  quickly 
follows.  Whether  the  pulsation  of  the  heart  could  be  rees- 
tablished was  first  investigated  by  Schiff  ^in  1874,  and  in 
animals,  by  means  of  rhythmical  compression  of  the  heart 
by  the  hand,  he  succeeded  in  starting  the  heart  beating. 
It  is  impossible  for  me  to  state  in  detail  the  experiments  of 
Pruss  in  1889  and  Battelli  in  1900,  both  of  whom  were  able 
in  a  considerable  number  of  animals  and  by  various  meth- 
ods to  reestablish  cardiac  pulsation.  The  most  extraordi- 
nary experiments,  however,  were  made  by  Kuliabko  in  1902 
on  hearts  which  had  been  removed  from  the  body;  all  prior 
experiments  having  been  made  on  hearts  remaining  in  the 
body  of  the  animal.  Kuliabko  showed  that  after  the  heart 
had  been  removed  from  the  animal  and  kept  in  ice  for 
twenty-four  or  even  forty-four  hours,  by  filling  the  heart 
with  certain  fluids  pulsation  was  reestablished  and  con- 
tinued for  over  three  hours.  He  was  able  also  to  take  the 
hearts  from  rabbits  that  had  died  a  natural  death  instead 
of  having  been  killed,  and  on  even  the  second,  third,  and 
fourth  day  after  death,  by  filling  them  with  this  fluid  the 
isolated  heart  was  started  pulsating  and  continued  to  beat 


AND  MEDICAL  PROGRESS  153 

for  several  hours.  He  also  tried  the  experiment  in  a  number 
of  instances  in  which  the  human  heart  was  removed,  post 
mortem,  even  as  long  as  thirty  hours  after  death,  and  pro- 
duced temporary  pulsation.  In  a  dog*s  heart  which  had 
been  in  snow  for  eighteen  hours,  and  again  after  having 
been  frozen  in  salt  solution  for  twenty-four  hours,  Vehch 
obtained  slight  contractions,  but  full  pulsation  was  not 
reached. 

Very  naturally  such  experiments  aroused  the  hope  that 
some  similar  result  might  be  reached  in  man.  Attempts 
were  made  in  desperate  cases  of  sudden  death,  especially 
from  chloroform.  Ricketts  has  collected  thirty-nine  cases, 
of  which  twelve  recovered!  In  other  cases  the  circulation 
has  been  reestablished  for  a  number  of  hours,  so  that  the 
surgeons  were  justified  in  expecting  the  recovery  of  the 
patients,  but  after  a  time  the  pulse  and  respiration  failed, 
and  recovery  did  not  follow. 

As  can  easily  be  seen,  all  this  is  so  new  that  it  is  impos- 
sible at  present  definitely  to  fix  on  the  best  method  of 
reaching  the  heart,  whether  (as  in  cases  of  wounds  of  the 
heart)  by  making  a  trap-door  over  it  in  the  wall  of  the 
chest,  or  by  quickly  opening  the  abdomen  and  reaching  the 
heart  through  the  diaphragm,  or  by  other  means  which  are 
too  technical  for  me  to  describe.  The  report  of  the  thirty- 
nine  cases  alluded  to  gives  a  recovery  rate  of  thirty-one 
per  cent.  That  this  will  be  increased  in  time  there  is  no 
doubt. 

The  most  recent  researches  in  the  surgery  of  the  heart 
are  experiments  on  animals  to  determine  whether  it  is 
possible  not  only  to  expose  the  heart  and  operate  on  its 
exterior,  but  deliberately  to  open  its  cavities  and  operate 
on  the  valves.  The  results  so  far  seem  to  show  that  it  is  no 
dream  of  a  surgical  Utopia,  but  that  some  day  "valvular 
disease  of  the  heart,"  hitherto  an  absolutely  incurable  dis- 
sease,  may  be  dealt  with  surgically  and  with  the  possibility 
of  success.  Happy  the  surgeon  who,  after  suitable  experi- 


154  ANIMAL  EXPERIMENTATION 

ments  upon  animals  have  taught  him  exactly  how  to  do  it, 
may  be  able  to  cure  such  a  hopeless  malady !  ^ 

But  the  happy  history  of  progress  is  not  yet  all  told. 
Three  years  ago  I  saw  Dr.  Crile,  of  Cleveland,  chloroform 
a  dog  to  death.  By  a  suitable  apparatus  he  was  able  accu- 
rately to  record  the  very  last  pulsation  of  the  heart  and  the 
last  attempt  at  breathing.  I  stood  by  the  dog,  watch  in 
hand,  and  when  he  had  been  dead  —  having  neither  pulsa- 
tion of  the  heart  nor  breathing  —  for  fifteen  minutes.  Dr. 
Crile  injected  toward  the  heart  in  the  carotid  artery  a 
mixture  of  salt  solution  and  adrenaUn  (the  extract  of  a 
gland  lying  just  above  the  kidney),  compressed  the  dog's 
chest  a  few  times,  thus  starting  the  heart  and  lungs  going, 
and  in  less  than  three  minutes  the  dog,  though,  of  course, 
still  unconscious  from  the  anesthetic,  was  just  as  much 
alive  as  he  had  been  a  half-hour  before.  Partial  but  not 
permanent  recovery  has  been  obtained  by  Dr.  Crile  in 
animals  even  twenty-five  minutes  after  actual  death.  If 
further  experience  confirms  these  results,  we  may  have  a 
better  method  of  resuscitation  in  collapse  of  the  heart  than 
by  exposing  it  as  above  described. 

Without  the  experiments  which  had  been  made  upon 
animals  and  proved  the  eflScacy  of  the  adrenalin,  which 
was  added  to  the  salt  solution,  no  one  would  have  thought 
that  the  extract  of  a  gland  lying  above  the  kidney  would 
be  of  the  least  value  in  saving  either  animal  or  human  life. 
We  know  now,  as  a  result  of  such  experiments,  and  with 
positive  certainty  the  effect  of  the  adrenalin  and  its  im- 
mense value  in  these  cases  as  well  as  in  others. 

Surgery  of  the  Arteries  and  Veins 

From  the  heart  naturally  we  pass  to  the  arteries,  which 
conduct  the  blood  from  the  heart  to  all  parts  of  the  body. 

*  Further  progress  has  been  made  by  Carrel  in  operating  on  the  valves 
in  animals,  but  it  is  not  yet  an  operation  so  safe  and  certain  as  to  warrant 
its  use  in  man.  (1914.) 


AND  MEDICAL  PROGRESS  155 

Wounds  of  the  arteries  by  gunshot,  by  stabs,  by  accidents, 
etc.,  are  not  at  all  uncommon.  Until  very  lately  when  a 
large  artery  or  a  large  vein  was  wounded  our  only  remedy 
was  to  cut  down  upon  the  blood-vessel  and  tie  it  above  and 
below  the  wound.  If  it  were  an  artery  leading  to  the  arm, 
and  still  more  if  it  were  one  leading  to  the  leg,  as  the  prin- 
cipal supply  of  blood  was  cut  off,  gangrene  was  a  very 
common  result. 

In  case  of  aneurysm  (a  disease  in  which  the  walls  of  the 
artery  become  weakened  at  a  certain  point,  bulge,  and 
finally  rupture,  producing  death),  till  recently,  as  in  the  case 
of  a  wounded  artery,  our  only  resource  was  to  expose  the 
artery  and  tie  it.  Here  again,  for  the  same  reason,  the  chief 
danger  was  gangrene.  In  the  treatment  of  aneurysm, 
Matas,  of  New  Orleans,  has  made  the  greatest  improve- 
ment since  the  days  of  John  Hunter,  over  a  century  ago. 
Instead  of  tying  the  artery  above  the  aneurysm  and  arrest- 
ing the  current  of  blood  in  the  artery,  he  opens  the  sac 
(that  is,  the  dilated  portion  of  the  artery  or  aneurysm), 
and,  if  I  may  so  describe  it,  sews  the  opposite  walls  of  the 
sac  together  on  the  inside,  leaving,  however,  a  small  tun- 
nel through  which  the  circulation  is  continued. 

Up  to  June,  1908,  eighty-five  operations  of  this  kind  have 
been  done,  with  seventy-eight  recoveries.  This  method  of 
operating  obviates  almost  entirely  the  danger  of  gangrene. 
Thus  far  apparently  European  surgeons  have  neglected  it, 
only  two  operations  having  been  done  in  Italy  and  four  in 
Spain,  while  the  remaining  seventy-nine  have  been  done  in 
America. 

But  it  is  in  cases  of  wounds  of  arteries  and  veins  that 
perhaps  the  most  remarkable  progress  has  been  made,  and 
the  story  shows  how  widespread  are  the  benefits  derived 
from  a  single  discovery  —  how  to  sew  together  the  two  ends 
of  an  artery  which  has  been  cut  across.  When  a  blood-ves- 
sel was  wounded,  we  were  obliged  to  tie  the  artery  or  vein 
to  prevent  the  patient  from  bleeding  to  death.  As  I  have 


156  ANIMAL  EXPERIMENTATION 

explained,  this  cutting  off  of  the  blood-supply  often  pro- 
duced gangrene.  In  1894,  Dr.  Robert  Abbe,  of  New  York, 
made  a  number  of  remarkable  experiments  upon  animals; 
among  them  two  are  especially  noteworthy.  Opening  the 
abdomen  of  a  cat,  he  cut  across  the  aorta  (the  great  blood- 
vessel passing  directly  from  the  heart  to  the  lower  limbs) 
and  inserted  a  thin  sterile  glass  tube,  tying  the  aorta  over 
flanges  made  at  the  two  ends.  After  four  months  the  cat 
was  shown  at  the  New  York  Academy  of  Medicine,  "fat 
and  strong,  with  the  glass  tube  still  in  his  aorta.'*  Again,  he 
almost  amputated  a  dog's  foreleg,  leaving  the  limb  at- 
tached to  the  body  by  nothing  but  the  artery  and  vein.  He 
then  wired  the  two  ends  of  the  bone  together,  sewed  muscle 
to  muscle,  nerve  to  nerve,  etc.,  and  after  dressing  the  limb, 
encased  it  in  plaster.  After  four  months  this  almost  ampu- 
tated limb  was  perfectly  united,  and  Dr.  Abbe  drew  the 
inference  that  a  completely  amputated  limb  might  be  suc- 
cessfully grafted.  How  fruitful  these  experiments  were  in 
practice  we  shall  see  later. 

When  an  artery  is  partially  divided  or  completely  cut 
across,  naturally  the  proper  course  would  be  in  the  former 
case  to  sew  up  the  wound,  or  in  the  latter  to  sew  the  two 
ends  of  the  blood-vessel  together,  and  so  reestablish  the 
circulation.  To  describe  all  of  the  technical  difficulties  of 
such  an  operation  would  be  impossible  in  a  brief  paper. 
They  have  been  investigated  experimentally  by  Murphy, 
of  Chicago;  Payr,  of  Graz;  Crile,  of  Cleveland;  Carrel,  of 
New  York;  Guthrie,  of  St.  Louis,  and  others. 

The  great  difficulty  has  been  to  find  a  suitable  method  of 
sewing  the  two  ends  of  a  completely  divided  artery  together 
in  such  a  way  that  the  blood  will  not  form  a  clot  at  the  neces- 
sarily somewhat  rough  and  irregular  hne  of  union  and 
totally  obstruct  the  vessel  just  as  if  it  had  been  tied.  At  last, 
within  the  past  few  years,  especially  by  the  labors  of  Carrel, 
Guthrie,  and  Crile,  a  suitable  method  has  been  devised  by 
which  now  any  surgeon,  who  will  familiarize  himself  with 


AND  MEDICAL  PROGRESS  157 

the  process  and  obtain  skill  in  its  application  by  a  few  ex- 
periments upon  animals,  can  operate  in  such  cases  with 
confidence.  This  method  has  not  only  found  its  chief  appli- 
cation when  the  blood-vessels  have  been  completely  di- 
vided, but  has  made  possible  another  very  remarkable 
achievement;  namely,  direct  transfusion  of  blood. 

The  older  method  of  transfusion  was  to  connect  the  ar- 
tery of  a  healthy  person  with  the  vein  of  the  patient  by 
means  of  a  rubber  tube.  The  great  danger  here,  as  in  the 
case  of  wounds  of  the  artery,  was  that  the  blood  would  clot. 
K  this  clot  passed  into  the  vein,  whether  of  arm  or  leg,  it 
went  upward  till  it  finally  reached  the  heart,  and  was  then 
driven  into  the  lungs,  where  it  would  act  like  a  cork  and 
bl6ck  up  a  larger  or  smaller  artery  of  the  lung,  cutting  off 
the  circulation  in  that  part  and  producing  a  dangerous  and 
in  most  cases  a  fatal  pneumonia.  So  great  was  this  danger 
and  so  frequent  the  disaster  following  indirect  transfusion 
by  this  means  that  for  a  number  of  years  it  has  been  prac- 
tically abandoned.  Instead,  therefore,  of  transfusing  blood 
itself,  surgeons  have  for  some  years  relied  upon  supplying 
the  loss  in  volume  of  the  blood  by  means  of  salt  solution, 
and  this  in  very  many  cases  has  answered  very  well.  As  a 
result,  however,  of  these  recent  experiments  on  the  suture 
(sewing)  of  blood-vessels  end  to  end,  we  now  are  in  a  posi- 
tion to  pass  the  blood  from  the  artery  of  a  healthy  person 
into  a  vein  of  the  patient  without  any  danger  of  its  clotting, 
provided  the  operation  is  properly  done.^  This  has  had  a 
very  striking  climax  in  certain  cases  in  which  there  has  been 
severe  loss  of  blood.  Let  me  give  but  one  very  briefly  — 
the  case  of  the  baby  of  a  well-known  young  medical  man. 
Immediately  after  the  birth  of  this  baby,  there  set  in  severe 
hemorrhages  from  the  mouth,  nose,  stomach,  and  bowels, 
the  so-called  "hemorrhage  of  the  newborn."  The  various 

*  As  a  result  of  these  and  many  other  remarkable  researches  by  animal 
experimentation,  Carrel,  in  1912,  was  awarded  the  Nobel  Prize  ($40,000) 
in  Medicine. 


158  ANIMAL  EXPERIMENTATION 

remedies  which  were  tried  all  failed,  and  on  the  fourth  day 
the  baby  was  dying.  I  am  sure  that  every  woman,  espe- 
cially, will  sympathize  with  the  grief  of  these  parents  over 
the  impending  death  of  their  firstborn.  In  the  middle  of  the 
night  the  father  called  Dr.  Carrel,  of  the  Rockefeller  Insti- 
tute, to  his  assistance,  lay  down  alongside  of  his  baby,  an 
artery  in  the  father's  arm  was  laid  bare  and  sewed  end  to 
end  to  a  vein  in  the  baby's  leg,  and  the  blood  was  allowed  to 
flow  from  father  to  child.  The  result  was  most  dramatic. 
A  few  moments  after  the  blood  began  to  flow  into  the 
baby's  veins  its  white,  transparent  skin  assumed  the 
ruddy  glow  of  health.  The  hemorrhage  from  every  part  of 
the  body  ceased  instantly  and  never  returned,  and,  as  the 
pubUshed  account  ^  so  vividly  puts  it,  there  was  no  period 
of  convalescence  —  immediately  before  the  operation,  the 
baby  was  dying;  immediately  after  the  operation,  it  was 
well  and  strong  and  feeding  with  avidity.  That  baby 
to-day  is  a  strong,  healthy  child. 

The  same  method  of  direct  transfusion  has  been  used  by 
Crile,  Downes,  of  New  York,  and  others,  in  a  still  different 
way.  Many  patients  come  to  surgeons  so  weak,  either  from 
loss  of  blood  or  from  the  dreadful  effects  of  cancer,  tumors 
and  other  diseases,  that  to  operate  upon  them  with  the 
coincident  shock  and  loss  of  blood  is  almost  sure  to  be  fatal. 
In  such  cases  very  frequently  prudent  surgeons,  to  their 
great  grief,  are  obliged  to  say  "no,"  and  allow  the  patient 
to  die  rather  than  attempt  an  operation. 

In  a  child  two  years  and  two  months  old,  Downes  found 
a  tumor  of  the  kidney  which  filled  the  entire  left  half  of  the 
abdomen,  and  in  whom  the  quality  of  the  blood  (the  hemo- 
globin) was  reduced  to  forty-five  per  cent  of  the  normal;  the 
child's  face  was  drawn,  the  pulse  rapid  and  feeble,  and  the 
appetite  very  poor.  Operation  was  delayed  for  a  few  days 
in  order  to  see  whether  good  care  and  good  food  would  not 
cause  improvement.  On  the  contrary,  the  child  was  no 
1  New  York  Medical  Record,  May  30,  1908. 


AND  MEDICAL  PROGRESS  159 

better,  and  there  was  a  measurable  increase  in  the  size  of 
the  tumor,  so  rapidly  was  it  growing.  On  September  11, 
the  father's  artery  and  the  child's  vein  were  united  and  the 
blood  allowed  to  pass  from  father  to  child  for  forty  minutes. 
Every  five  minutes  the  quality  of  the  blood  of  the  child  was 
tested  by  taking  a  few  drops  of  it,  and  it  was  found  that  at 
the  end  of  forty  minutes  the  quality  of  the  blood  had  risen 
from  forty-five  per  cent  to  eighty  per  cent.  The  pulse  was 
full  and  strong,  and  the  child's  color  and  general  condition 
showed  equal  improvement.  On  the  following  day  the  tu- 
mor, weighing  a  pound  and  two  ounces,  together  with  the 
left  kidney,  was  removed,  and  the  patient  was  discharged 
perfectly  well  on  October  18,  having  already  gained  three 
pounds  in  weight. 

Crile  has  even,  if  possible,  in  a  more  striking  way  demon- 
strated the  use  of  this  method  in  eleven  successful  cases  in 
human  beings.  Instead  of  effecting  the  transfusion  a  day 
or  two  before  the  operation,  he  has  placed  the  patient  and 
her  husband  alongside  of  each  other  at  the  time  of  the  oper- 
ation, connected  the  husband's  artery  with  the  wife's  vein, 
and  as  soon  as,  from  the  inflowing  blood,  her  condition  has 
improved  suflSciently  to  withstand  the  etherization,  the 
shock,  and  the  loss  of  blood,  has  proceeded  with  the  opera- 
ation.  During  the  operation  the  loss  of  blood  by  the  patient 
has  been  more  than  made  up  by  her  gain  from  her  hus- 
band's blood,  and  she  has  been  enabled  to  withstand  the 
shock  incident  to  the  ether  as  well  as  the  operation;  and  at 
the  end  of  the  operation  she  has  been  in  better  condition 
than  before  it  was  begun.  As  Crile  has  declared,  "In  some 
cases  the  results  seem  nothing  short  of  a  resurrection  from 
the  dead." 

Recently  a  nephew  of  Bishop  Lawrence,  of  Massachu- 
setts, was  thus  rescued  by  direct  transfusion  of  blood.  To 
quote  the  Bishop's  exact  words,  "The  boy  was  at  death's 
door,  and  is  now  in  perfect  health." 


160  ANIMAL  EXPERIMENTATION 

Transplantation  of  Parts  of  the  Body 

Our  ability  successfully  to  sew  severed  blood-vessels 
together  has  borne  still  further  fruit.  It  has  enabled  us  to 
transplant  whole  organs  —  for  example,  one  or,  in  other 
cases,  both  kidneys,  or  an  entire  leg  from  one  animal  to 
another.  These  possibihties,  however,  have  only  been  real- 
ized step  by  step,  not  only  by  devising  successful  methods 
of  sewing  the  ends  of  large  vessels  together,  but  by  discov- 
ering that  nature  can  supply  a  transplanted  part  spontane- 
ously with  small  blood-vessels  and  thus  enable  it  to  retain 
its  vitality. 

Everybody,  for  instance,  knows  about  "skin-grafting." 
Reverdin,  of  Geneva,  first  snipped  off  httle  pieces  of  skin 
from  the  arm  or  leg  and  deposited  these  pieces  on  the  sur- 
face of  an  ulcer,  protecting  them  by  suitable  dressings  from 
being  displaced.  He  found  that  these  little  pieces  when 
placed  on  the  ulcer  adhered  to  it,  that  they  lived,  that 
small  blood-vessels  nourished  them,  and  around  each  little 
island  of  transplanted  skin  the  ulcer  began  to  scar  over 
(cicatrize),  and  finally  healed.  This  emboldened  Krause,  of 
Berlin,  to  take  much  larger  pieces  of  skin,  so  that  at  present 
after  removing  a  tumor,  if  we  cannot  bring  the  margins  of 
the  skin  together,  we  cut  from  the  thigh  of  the  patient  long 
strips  of  thin  skin  an  inch  wide  and  several  inches  long  by 
means  of  a  sharp  razor  and  transfer  them  to  the  raw  spot. 
As  a  rule,  they  adhere,  preserve  their  vitality,  are  nourished 
by  new  small  blood-vessels,  and  in  a  short  time  we  can  thus 
"skin-graft"  a  large  raw  surface  and  have  it  heal.  The 
thing  quickly  heals. 

But  this  kind  of  "grafting"  is  not  limited  to  the  skin. 
Many  years  ago  Oilier,  of  Lyons,  showed  that  by  taking 
from  the  bone  of  a  living  animal  a  bit  of  the  membrane 
which  covers  all  bones  (the  periosteum),  he  could  trans- 
plant it  to  another  place  on  the  same  animal,  or  even  into 
another  animal,  and  the  periosteum  would  produce  new 


AND  MEDICAL  PROGRESS  161 

bone.  Following  that  discovery,  which  was  the  result  of 
laborious  experiments,  we  constantly  now  make  what  are 
called  "subperiosteal"  removals  —  for  example,  of  a  part 
or  the  whole  of  a  lower  jaw  —  preserving  the  periosteum, 
and  from  it  a  new  more  or  less  perfect  bone  is  developed. 

Recently  Lexer,  of  Konigsberg,  has  gone  much  farther. 
In  the  case  of  a  man  who  had  a  stiff  knee-joint  bent  at  an 
angle  and  immovably  fixed  by  firm  bony  union,  he  removed 
the  bones  forming  the  knee-joint  and  took  from  an  ampu- 
tated leg  the  healthy  knee-joint  and  put  it  in  place  of  the 
bone  that  he  had  removed  from  the  stiff  knee.  The  trans- 
planted bones  both  above  and  below  united  firmly  with  the 
bones  of  the  patient,  and  the  strange  knee-joint  from  the 
amputated  leg  served  a  perfectly  normal  function.  In 
another  case  he  removed  the  upper  end  of  the  shin  bone, 
taking  away,  therefore,  the  lower  half  of  the  knee-joint  (a 
much  more  difficult  and  dangerous  operation,  as  it  opened 
the  knee-joint),  and  replaced  this  with  a  similar  portion  of 
bone  from  an  amputated  leg  with  entire  success. 

The  last  achievement  that  I  have  seen  of  this  ingenious 
surgeon  was  reported  to  the  German  Surgical  Congress  in 
April,  1908.  Most  of  my  readers  are  famiUar  with  the  fact 
that  when  a  patient,  through  disease  or  accident,  has  lost 
his  nose  a  new  one  can  be  made  for  him.  This  is  a  very 
ancient  operation.  The  new  nose  is  usually  made  by  cut- 
ting a  flap  from  the  forehead,  leaving  it  attached  by  a  foot- 
stalk between  the  eyebrows.  This  flap  is  then  twisted  on  its 
footstalk  and  sewed  in  place.  But  it  has  serious  disadvan- 
tages. Sometimes  the  twist  in  the  footstalk  is  too  tight; 
this  compresses  the  blood-vessels,  and  the  flap  becomes 
gangrenous.  In  that  case  not  only  has  the  patient  lost  his 
nose,  but  he  is  left  with  a  face  disfigured  by  a  great  scar  in 
the  middle  of  his  forehead.  Even  if  the  attempt  to  give  him 
a  new  nose  is  a  success,  the  scar  on  the  forehead  always 
tells  the  story,  and,  moreover,  the  new  nose,  having  no 
bone,  is  flabby  and  unsightly.  Lexer  records  a  case  which  is 


162  ANIMAL  EXPERIMENTATION 

not  only  surprising,  but  one  may  say  also  amusing.  Having 
a  patient  requiring  a  new  nose,  and  having  amputated  a  leg 
for  some  disease  which  did  not  involve  the  thigh  bone,  he 
took  a  bit  of  the  lower  end  of  this  thigh  bone,  whittled  it 
into  the  shape  of  a  nose,  and  bored  out  two  nostrils  in  it. 
He  then  made  an  incision  in  the  skin  of  the  forearm  of  the 
patient,  on  the  front,  or  hairless  surface,  loosened  the  skin 
to  some  extent  from  the  underlying  muscles,  placed  the 
new  bony  nose  under  the  skin,  and  closed  the  wound. 
After  three  months,  when  the  skin  of  the  forearm  had 
become  firmly  attached  to  the  bony  nose  (which  was  only 
intended  to  be  a  temporary  tenant  of  his  forearm)  the  skin 
and  the  new  bony  nose  were  cut  out  in  one  piece  and  trans- 
planted to  the  face.  This  gave  the  patient  a  good,  firm, 
bony  nose,  which  at  the  same  time  was  covered  with  the 
healthy  skin  of  the  forearm,  and  avoided  any  disfiguring 
scar  on  the  forehead. 

Even  more  surprising  things  have  been  done  by  Carrel 
and  Guthrie  in  the  transplantation  of  soft  parts  which  had 
been  preserved  by  various  means,  and  yet  grew  fast  and 
fulfilled  their  function.  For  example,  in  November,  1906, 
Carrel  removed  from  the  neck  of  a  dog  a  portion  of  the 
carotid  artery,  and  put  it  into  cold  storage,  where  it  was 
kept  at  an  even  temperature  of  32°  to  33°  F.  After  twenty 
days  in  cold  storage  he  transplanted  this  into  the  aorta  of  a 
cat,  and  after  two  years  and  one  month  the  cat  was  per- 
fectly well.  Again,  in  May,  1907,  a  portion  of  a  dog's  aorta 
was  removed,  and  a  similar  portion  of  the  artery  behind  the 
knee  removed  from  the  amputated  leg  of  a  man  was  put  in 
its  place,  and  eighteen  months  later  the  dog  was  still  in 
thoroughly  good  condition. 

Guthrie  also  reports  that  he  removed  from  a  dog  a  por- 
tion of  the  great  vein  alongside  the  aorta  (the  vena  cava), 
preserved  it  by  formalin  (a  chemical  preservative)  for  sixty 
days,  then  removed  a  corresponding  portion  of  the  carotid 
artery  from  the  neck  of  another  dog  and  replaced  it  by  this 


AND  MEDICAL  PROGRESS  163 

portion  of  vena  cava,  and  the  animal  was  living  and  well 
when  the  report  was  made  three  weeks  later. 

Still  more  extraordinary  experiments  have  been  done  by 
Carrel  and  Guthrie  in  the  transplantation  of  entire  legs  or 
of  entire  organs.  Carrel  amputated  the  thighs  of  two  dogs, 
A  and  B,  and  united  the  thigh  from  dog  A  to  the  stump  of 
the  thigh  of  dog  B,  wired  the  ends  of  the  bones  together, 
sewed  artery  to  artery  and  vein  to  vein,  etc.  (it  will  be  seen 
now  how  essential  was  the  discovery  of  a  successful  method 
of  sewing  the  arteries  end  to  end),  and  applied  a  suitable 
dressing  and  a  plaster  cast.  The  new  leg  grew  fast  to  the  old 
stump,  and  when  I  personally  saw  it  there  was  firm  union. 

This  experiment,  which  has  also  been  done  by  Guthrie, 
is  only  a  further  step,  it  will  be  observed,  beyond  the  oper- 
ation of  Abbe  in  1894,  when  he  amputated  the  entire  leg 
with  the  exception  of  the  blood-vessels,  which  he  dared  not 
cut,  for  with  the  imperfect  knowledge  we  poseesssd  fifteen 
years  ago  he  could  not  possibly  have  successfully  sewed 
them  together. 

Quite  as  noteworthy  also  are  some  experiments  of  Carrel 
and  Guthrie  in  which  they  have  taken  the  two  kidneys  with 
their  blood-vessels  and  the  corresponding  part  of  the  aorta 
and  the  vena  cava,  the  two  ureters,  and  the  part  of  the 
bladder  into  which  the  ureters  entered,  from  one  cat,  and 
transplanted  them  into  another  cat  from  which  the  same 
parts  had  been  removed.  I  saw  this  operation  done  a  few 
months  ago  in  an  hour  and  a  half.  An  hour  after  the  opera- 
ation  the  cat  was  in  very  much  better  shape  than  most  of 
my  patients  are  an  hour  after  I  am  through  with  them. 
She  recovered  perfectly,  and  the  transplanted  kidneys 
worked  as  well  in  the  second  cat  as  they  had  done  in  the 
body  of  the  original  one. 

Cancer 

The  surgical  record  of  cancer  consists  of  a  happy  achieve- 
ment and  a  temporary  failure.   The  achievement  is  the 


164  ANIMAL  EXPERIMENTATION 

practically  permanent  cure  of  forty  to  fifty  per  cent  (and 
some  surgeons  have  had  even  a  larger  percentage)  of  the 
cases  operated  upon:  that  is  to  say,  patients  who  have  had 
cancerous  tumors  removed  have  lived  for  five,  ten,  fifteen, 
and  even  twenty  years  without  any  recurrence.  This  has 
been  gained  by  the  most  painstaking  study  of  the  modes  of 
extension  of  the  disease  and  by  more  thorough  and  earHer 
extirpation.  I  presume  even  now,  with  our  imperfect 
knowledge  of  cancer,  if  every  patient  who  found  a  lump  in 
any  part  of  the  body  would  seek  the  best  available  surgeon, 
it  would  be  within  the  bounds  of  truth  were  I  to  say  that, 
taken  at  this  early  stage,  the  cures  would  probably  amount 
to  sixty -five  or  even  seventy-five  per  cent  of  the  cases  oper- 
ated on.  But  what  all  surgeons  are  seeking  is  (1)  the  cause 
and  (2)  the  means  of  cure  of  cancer  without  operation  — a 
professional  altruism  which  I  never  cease  to  admire. 

That  cancer  is  mildly  contagious  is  shown  by  the  un- 
doubted existence  of  the  so-called  ** cancer  houses"  in 
which,  for  want  of  proper  disinfection,  repeated  cases  of 
cancer  have  arisen.  Moreover,  animal  experimentation 
and  a  few  cases  in  human  beings  have  shown  that  if  the 
cancer  cells  of  the  tumor  come  in  contact  with  a  fresh  raw 
surface  during  operation,  the  disease  may  easily  be  spread 
in  this  way.  Hence  every  modern  surgeon  is  extremely 
careful  to  protect  the  raw  surface  of  the  wound  from  touch- 
ing, even  momentarily,  the  cancerous  tissues  or  being 
moistened  with  their  dangerous  juices.  For  the  same  rea- 
son our  operative  methods,  too,  have  been  changed,  so  that 
now  we  take  out  the  entire  mass  of  infected  glands  as  well 
as  the  original  tumor  in  a  single  piece,  and  never  put  a  knife 
into  any  of  the  cancerous  tissues.  If  we  are  obliged  to  do  so, 
this  knife  is  cast  aside  and  a  new  one  substituted. 

The  cancer  problem  is  being  attacked  vigorously  in  can- 
cer laboratories  in  Buffalo,  Boston,  London,  Heidelberg, 
New  York,  and  elsewhere  with  extraordinary  zeal.  Many 
men  are  devoting  their  lives  wholly  to  the  study  of  this 


AND  MEDICAL  PROGRESS  165 

one  great  and  perplexing  problem.  It  is  being  attacked  on 
the  clinical  side  to  see  if  we  can  learn  anything  by  such  ex- 
perience; by  the  microscopists  to  find  if  the  minute  study 
of  the  tissues  will  reveal  the  cause;  by  the  bacteriologists 
to  see  if  they  can  discover  any  germ  which  may  originate 
the  tumor;  and  finally  by  animal  experimentation  to  study 
the  life  history  of  such  tumors  from  start  to  finish  by  inoc- 
ulating animals  with  the  cancerous  tissue  and  tracing  the 
effect  of  the  inoculation,  destroying  one  animal  at  the  end 
of  a  few  days,  another  in  two  or  three  weeks,  another  in 
months,  and  so  on;  and  in  a  multitude  of  other  ways  too 
technical  to  relate,  in  order  to  obtain  the  most  intimate 
and  exact  knowledge  possible.  But  so  far  the  cause  of 
cancer  has  eluded  us. 

I  have  called  this  a  temporary  failure  because  I  look 
forward  with  confidence  to  the  future.  At  any  moment  I 
am  expecting  to  learn  that  some  pathologist  will  really 
discover  the  cause  of  cancer  (for  many  have  cried,  Lo  here ! 
or,  Lo  there!  only  to  find  they  were  in  error),  and  thus  con- 
fer a  boon  on  the  human  race  second  only  to  the  discovery 
of  the  bacillus  of  tuberculosis. 

Let  us  now  turn  to  another  subject,  in  which,  once  more, 
the  question  of  transplantation  of  organs  will  come  up  for 
consideration. 

Goiter 

This  disease  is  well  known,  of  course,  to  all  who  have 
traveled  in  Switzerland  and  Savoy,  where  such  an  immense 
number  of  cases  occur.  That  it  is  not  very  uncommon  in 
America  is  shown  by  the  fact  that  the  Mayo  brothers  have 
done  over  one  thousand  operations  for  goiter.  In  my  paper 
in  October,  1889, 1  referred  to  what  was  an  amazing  report 
in  that  year  by  Kocher,  of  Berne,  of  two  hundred  and 
fifty  operations  for  goiter,  with  a  mortality  of  but  2.4  per 
cent.  The  last  statistics  which  have  been  published  by 
Kocher  cover  three  thousand  operations  for  goiter,  with  the 


166  ANIMAL  EXPERIMENTATION 

marvelously  low  mortality  of  only  three  deaths  in  each  one 
thousand  cases. 

When  we  began  to  operate  on  goiters,  the  whole  of  the 
thyroid  gland  (the  enlargement  of  which  produces  the 
goiter)  was  removed.  It  was  soon  found,  however,  that  in  a 
certain  percentage  of  cases  the  patients  underwent  a  dread- 
ful change;  namely,  they  looked  as  though  they  were 
bloated;  their  hands  and  features  became  thickened  and 
enlarged;  their  intellects  became  dulled,  so  that  some  of 
them  even  passed  into  the  state  of  cretinism.  Others,  on 
the  other  hand,  became  greatly  excited,  and  died  with  what 
is  known  as  tetany,  a  disease  which  derives  its  name  from 
its  resemblance  in  many  respects  to  tetanus  or  lockjaw.  In 
order  to  obviate  these  dangers  the  first  change  that  was 
made  was  to  leave  a  portion  of  the  gland  behind.  If  this 
was  done,  the  patient  was  not  attacked  by  the  general 
change  (myxedema  or  cretinism),  though  fatal  tetany  still 
sometimes  followed. 

In  1880,  Sandstrom  discovered  in  the  human  subject 
some  small  glands  about  the  size  of  grains  of  wheat,  situ- 
ated behind  the  thyroid  gland,  but  in  immediate  connec- 
tion with  it,  and  therefore  called  the  parathyroid  glands. 
Human  beings  and  many  animals  usually  have  four,  some- 
times three,  and  sometimes  only  two.  Moreover,  their  situ- 
ation varies  very  much,  and  at  first  it  was  impossible  to 
recognize  them  at  operation.  What  their  function  was,  and 
what  would  be  the  effect  of  their  removal,  nobody  knew. 
Accordingly,  experiments  were  begun  upon  the  lower  ani- 
mals by  removing  some  or  all  of  these  glands  in  order  to 
discover  their  function.  It  was  quickly  learned  that  when 
they  were  all  removed,  the  animals  died  from  tetany,  just 
as  human  beings  occasionally  did  after  operations  for 
goiter.  Then  it  was  suspected  that  the  cause  of  the  human 
tetany  was  not  the  removal  of  the  thyroid  gland  itself,  but 
of  these  little  parathyroids,  and  that  the  good  effect  of 
leaving  a  part  of  the  thyroid  gland  was  due  not  only  to 


AND  MEDICAL  PROGRESS  167 

leaving  the  thyroid  itself,  but  to  accidentally  leaving  at 
least  one  of  these  little  glands.  Numerous  experiments 
upon  animals,  as  well  as  the  terrible  experiments  which  we 
had  been  ignorantly  making  upon  human  beings,  from 
whom  many  surgeons,  without  knowing  it,  had  removed 
these  parathyroid  glands,  have  shown  that,  small  as  they 
are,  they  are  essential  to  life,  and  that  if  they  are  all  re- 
moved, the  withdrawal  of  the  secretion  they  furnish  to  the 
body  always  causes  death. 

At  the  German  Surgical  Congress  in  April,  1908,  Kocher 
reported  that  he  had  transplanted  these  glands  for  certain 
reasons  into  the  upper  end  of  the  shin  bone  just  below  the 
knee.  This  he  did  first  in  animals,  and  found  that  when,  at 
a  later  operation,  he  removed  the  whole  of  the  thyroid 
gland  and  the  parathyroids  from  the  neck,  the  animals  did 
not  suffer  from  tetany.  He  has  now  gone  a  step  farther,  as 
his  animal  experimentation  justified  him  in  doing,  and  has 
done  a  similar  transplantation  in  the  human  subject.  The 
results  of  this  operation  have  not  yet  been  published,  but 
I  judge  from  his  report  to  the  Surgical  Congress  that  it 
was  favorable.  If  so,  a  new  means  of  security  is  provided 
for  us  in  operations  for  goiter. 

There  is  another  form  of  goiter,  however,  which  is  much 
more  fatal  than  the  ordinary  goiter  with  which  most  people 
are  famiHar.  It  is  called  exophthalmic  goiter,  or  Graves's 
Disease,  the  latter  after  Graves,  of  Dublin,  the  former  be- 
cause the  eyes  protrude  very  markedly.  Along  with  these 
two  symptoms  there  is  a  very  fast  pulse,  running  up  to  160 
or  200.  The  disease  very  frequently  destroys  Ufe.  It  has 
been  operated  on  by  a  number  of  surgeons  with  a  good 
degree  of  success,  but  recently  an  antidote  has  been  pre- 
pared by  Rogers  and  Beebe  of  New  York  which  seems  to 
promise  much  in  the  way  of  cure  and  may  possibly  obviate 
operation.  One  of  the  gentlemen  most  interested  in  the 
development  of  this  antidote  was  spurred  on  in  his  experi- 
ments by  the  fact  that  his  own  wife  was  suffering  dread- 


168  ANIMAL  EXPERIMENTATION 

fully  from  the  disease  and  rapidly  nearing  the  grave.  The 
idea  of  preparing  this  anti-serum  or  antidote  had  come  to 
him  while  watching  the  action  of  another  anti-serum,  the 
whole  effect  of  which  was  spent  upon  the  kidney,  no  other 
organ  of  the  body  being  affected.  This  suggested  to  him 
the  idea  that  an  anti-serum  might  be  prepared  from  dis- 
eased thyroids  which  would  have  its  sole  effect  upon  the 
thyroid  gland.  Soon  after  this  fruitful  idea  had  developed 
in  his  mind,  a  patient  with  Graves's  Disease  died,  and  at 
the  post  mortem  he  obtained  the  thyroid  gland  from  this  un- 
fortunate patient.  With  this  a  number  of  rabbits  were  in- 
oculated, but  in  consequence  of  his  total  ignorance  of  the 
proper  method  of  using  it,  all  but  one  of  these  rabbits  died. 
From  this  one  rabbit  there  was  prepared  an  extraordinarily 
good  serum  which  absolutely  cured  three  human  beings 
and  partially  cured  two  others.  The  second  of  the  three 
who  were  cured  was  the  wife  of  the  doctor  himself.  Her 
attending  physician,  one  of  great  eminence,  had  declared 
to  her  husband  that  how  long  she  would  live  was  only  a 
question  of  hours.  By  reason  of  the  fact  that  its  instant  use 
was  imperative  before  it  could  be  thoroughly  tested  on 
animals  so  as  to  learn  its  dangers  and  how  to  avoid  them, 
he  nearly  killed  his  own  wife  in  the  attempt  to  cure  her;  but 
she  is  to-day  a  perfectly  well  woman,  thanks  to  the  experi- 
ments upon  this  small  number  of  rabbits. 

Reckoned  in  rabbits,  what  is  the  value  of  your  wife,  your 
husband,  or  your  child? 

All  of  this  animal  surgery  I  mention  for  two  reasons: 
first,  because  with  minor  exceptions  the  methods  and  the 
results  of  animal  surgery  and  of  human  surgery  are  identi- 
cal; and  therefore,  secondly,  because  it  is  a  necessary  pre- 
liminary and  precautionary  step  to  similar  surgery  in 
human  beings.  All  of  the  recent  surgery  in  animals  above 
described  will  surely  be  applied,  with  suitable  modifications, 
to  man,  immensely  adding  to  his  comfort  and  saving 


AND  MEDICAL  PROGRESS  169 

life,  with  all  which  that  implies  for  himself  and  his 
family. 

This  paper  is  a  record  of  only  a  few  of  the  wonderful 
achievements  of  modern  surgery  in  human  beings  which 
have  resulted  chiefly  from  experiments  on  the  lower  ani- 
mals. That  clinical  investigation  —  that  is,  investigation 
by  observation  at  the  bedside  —  has  been  of  value,  no  one 
doubts;  but  had  we  been  restricted  to  clincial  observation 
only,  not  a  tithe  of  the  progress  recorded  would  have  been 
made.  I  scarcely  know  anything  more  touching  than  the 
story  told  me  by  Dr.  Carrel  of  a  boy  who  wrote  to  him, 
offering  himself  for  experiments  of  any  kind,  if  by  so  doing 
he  could  obtain  a  pension  for  his  mother.  Not  long  since  I 
received  a  similar  letter  from  a  doctor  who  was  afflicted 
also  with  a  disease  which  he  knew  was  mortal.  He  wrote 
me  saying  that  he  was  willing  to  submit  to  any  opera- 
tion, however  painful,  without  any  anesthetic,  if  it  could  be 
of  any  use  to  humanity. 

Moreover,  this  progress  is  not  only  in  surgery,  but  in  medi- 
cine; and  doctors  have  been  in  the  forefront  in  sacrificing 
their  lives,  sometimes  by  accident,  sometimes  voluntarily, 
in  order  to  achieve  these  splendid  results.  Doctors  have 
died  by  diphtheria,  by  plague,  by  infection  of  various 
kinds,  have  slept  in  the  clothes  and  in  the  beds  of  yellow- 
fever  patients  in  order  to  discover  whether  the  fever  was 
spread  by  these  means,  and  have  offered  up  even  their 
lives  in  order  to  prove  that  yellow  fever  was  caused  solely 
by  the  mosquito,  and  thus  clinch  the  proof  that  was  needed 
in  order  that  this  dreadful  scourge  might  be  eliminated;  a 
scourge  which  has  cost  a  holocaust  of  Uves  and  millions  of 
dollars  even  in  the  United  States  alone. 

As  a  result  of  the  sacrifice  of  human  lives  Cuba  has  been 
freed  from  yellow  fever  for  the  first  time  in  nearly  two  cen- 
turies, and  in  the  Canal  Zone  not  a  case  of  yellow  fever  has 
occurred  for  over  four  years.  Colonel  Gorgas  is  the  one 
man  who  has  made  the  building  of  the  Panama  Canal  a 


170  ANIMAL  EXPERIMENTATION 

possibility.  No  lower  animal  being  subject  to  yellow  fever, 
experiments  could  not  be  tried  upon  them,  and  hence 
Lazear  and  others  lost  their  hves.  In  the  fine  words  on 
Lazear's  tablet  in  the  Johns  Hopkins  Hospital,  written  by 
President  Eliot : "  With  more  than  the  courage  and  devotion 
of  the  soldier  he  risked  and  lost  his  life  to  show  how  a  fear- 
ful pestilence  is  communicated  and  how  its  ravages  may  be 
prevented." 

I  am  old  enough,  perhaps,  to  relate  without  reproach  the 
following  personal  incident.  While  writing  this  paper  a 
friend  gave  me  the  "Journal  of  Zoophily"  for  January, 
1909.  On  page  21  found  in  an  editorial  note  on  a  large  gift 
by  its  founder  to  the  Rockefeller  Institute  the  following: 
"But  the  gift  only  fanned  into  fury  the  opposition  of  wo- 
men to  experiments  on  living  animals,  no  matter  how  great 
the  anticipated  benefit.''  Three  days  later,  between  noon 
and  bedtime,  I  happened  to  meet  four  former  patients,  all 
of  whom  thanked  me  warmly  for  having  saved  their  lives. 
Three  of  these  four  patients  owed  their  lives  chiefly  to  the 
knowledge  derived  from  experiments  upon  animals.  No 
further  comment  need  be  made  on  those  cruel  words  — 
"No  matter  how  great  the  anticipated  benefit."  With  a 
thrill  of  delight  I  fervently  thanked  God  for  what  modem 
surgery  could  do. 

For  what  the  friends  of  experimental  research  have  done, 
and  for  what  the  foes  of  experimental  research  have  done, 
see  "The  Influence  of  Antivivisection  on  Character," 
p.  234. 


THE  NEW  SURGERY  1 

In  "Harper's  Magazine"  for  April,  1909, 1  gave  a  brief 
account  of  the  newer  surgery  of  the  heart,  the  arteries,  and 
the  veins,  and  of  the  transplantation  of  different  parts  of 
the  body,  with  some  remarks  on  cancer  and  goiter. 

Further  transplantations  of  bone,  such  as  Lexer's,  which 
I  there  described,  have  been  reported  during  the  past  year. 
Streissler,  of  Gratz,  has  published  eighteen  such  cases;  some 
of  deformed  noses  made  straight  and  comely  by  pieces 
transplanted  from  the  shin  bone  of  the  patient,  after  being 
whittled  into  proper  shape  and  size;  others  in  which  an  inch 
or  more  of  the  arm  bone  has  been  removed  for  various  rea- 
sons and  the  gap  filled  also  by  pieces  of  the  shin  bone.  In 
fact,  this  bone  seems  to  be  the  usual  quarry  from  which  can 
be  had  all  the  necessary  building  material  for  such  opera- 
tions. Of  the  eighteen  cases  all  but  one  were  successful,  the 
limb  becoming  as  strong  and  useful  as  before  the  operation. 

In  the  present  paper  I  propose  to  describe  what  has  been 
accomplished  in  some  other  realms  of  surgery,  which  will 
show  the  remarkable  progress  made  possible,  especially 
with  the  aid  of  anesthesia,  antisepsis,^  and  experiment. 

Anesthesia 

Anesthesia  is  produced  in  several  different  forms.  (1) 
General  anesthesia  —  i.e.,  insensibility  to  pain  of  the  entire 
body;  (2)  local  anesthesia,  similar  insensibility  of  a  part  of 

*  Reprinted  by  the  kind  permission  of  Harper  &  Bros,  from  Harper's 
Magazine  for  July,  1910. 

2  Consult  the  remarkable  paper  by  President  Charles  W.  Eliot,  "The 
Fruits  of  Medical  Research  with  the  Aid  of  Anesthesia  and  Asepti- 
cism,"  delivered  October  16,  1909  (Ether  Day),  at  the  Massachusetts 
General  Hospital.  Pamphlet  No.  ix,  American  Medical  Association, 
Chicago.  (See  p.  xix.) 


172  ANIMAL  EXPERIMENTATION 

the  body;  and  (3)  spinal  anesthesia,  insensibility  produced 
by  injecting  an  anesthetic  around  the  spinal  cord. 

First,  general  anesthesia.  On  October  16,  1846,  the  first 
public  demonstration  of  the  use  of  ether  for  producing  gen- 
eral insensibility  to  pain  was  made  by  Morton  and  Warren 
at  the  Massachusetts  General  Hospital,  Boston.  On  No- 
vember 17,  1847,  chloroform  was  first  used  in  surgery  by 
Simpson  of  Edinburgh.  On  December  11,  1844,  Wells  had 
inhaled  nitrous-oxid  gas  and  had  a  tooth  painlessly  ex- 
tracted, but  it  was  not  until  1867  that  Colton  brought  the 
method  into  general  favor  by  a  report  of  twenty  thousand 
successful  inhalations. 

The  relative  danger  of  these  general  anesthetics  is  about 
as  follows :  chloroform  produces  one  death  in  two  thousand 
five  hundred  cases;  ether,  one  in  sixteen  thousand;  and 
nitrous  oxid,  one  in  two  himdred  thousand.  There  are 
several  other  general  anesthetics,  but  all  of  them  have  a 
larger  death-rate  than  ether  and  chloroform.  Nitrous  oxid 
is  by  far  the  safest  anesthetic,  but  the  difficulty  has  been 
that  one  cannot  perform  long  operations  with  it  on  account 
of  the  danger  from  asphyxia.  To  a  certain  extent  this  can 
be  remedied  by  administering  oxygen  with  the  ether.  Re- 
cently some  surgeons  have  performed  even  very  long  oper- 
ations by  this  method.  Possibly  this  may  prove  to  be  a  very 
important  advance  in  practical  anesthesia.^ 

Second,  local  anesthesia.  In  1884,  as  a  result  of  experi- 
ment upon  animals  (for  what  prudent  man  would  be  willing 
to  have  a  new  drug  which  might  blind  him  applied  to  his 
eye  without  such  a  proof  of  its  harmlessness?),  KoUer  first 
introduced  cocain  in  the  surgery  of  the  eye.  From  this 
beginning  its  use  has  become  greatly  broadened.  We  now 
inject  a  solution  first  into  the  skin  itself  and  then  into  the 
subcutaneous  tissue,  and,  by  means  of  this  "infiltration" 
method,  can  perform  even  large  operations.  About  1891, 

1  Crile  and  others  have  since  perfected  this  method  so  that  it  is  now 
(1914)  extensively  used. 


AND  MEDICAL  PROGRESS  173 

Schleich  in  Germany  showed  the  possibility  of  infiltrating 
the  tissues  with  a  very  weak  solution  of  one  tenth  of  one  per 
cent  instead  of  two  to  ten  or  even  twenty  per  cent  as  had 
been  used  at  first,  thus  avoiding  all  the  dangers  of  the 
stronger  solutions. 

In  1902,  Braun  conducted  a  series  of  experiments  with  a 
mixture  of  cocain  and  adrenalin.  This  added  greatly  not 
only  to  the  duration,  but  to  the  safety  of  local  anesthesia. 
Adrenalin  is  derived  from  a  little  body  called  the  adrenal 
or  supra-renal  gland,  which  is  situated  immediately  above 
the  kidney.  Adrenalin  was  first  discovered  by  Takamine,  a 
Japanese  physiological  chemist,  in  New  York  in  1901. 
Accurate  experiments  upon  animals  have  shown  that  the 
effect  of  this  powerful  agent  when  administered  in  a  very 
dilute  solution  is  to  contract  the  small  blood-vessels  in  dif- 
ferent parts  of  the  body.  But,  strange  to  say,  the  blood- 
vessels of  the  lungs  are  not  at  all  contracted,  and  therefore 
the  supply  of  blood  to  the  lungs  and  the  function  of  respira- 
tion are  not  affected  by  the  adrenalin.  By  its  effect  upon 
the  blood-vessels  elsewhere,  however,  the  anesthetic  action 
of  cocain  is  greatly  prolonged  and  also  intensified.  Hence 
its  frequent  use. 

Another  local  use  of  cocain  and  several  other  similar 
drugs  has  been  brought  to  the  notice  of  surgeons  in  the  last 
few  years  by  Crile  and  Gushing;  namely,  the  injection  of  a 
solution  of  cocain  directly  into  the  large  nerves  of  the  body 
before  dividing  them,  in  the  case  of  an  amputation.  For 
example,  in  any  amputation  above  the  knee,  or  at  or  above 
the  shoulder  joint,  we  have  to  divide  nerves  which  are  as 
large  as  a  lead-pencil,  or  even  a  little  finger.  Accurate  ob- 
servation both  in  animals  and  man  has  shown  that  when 
these  nerves  are  divided  a  great  fall  takes  place  in  the  blood 
pressure,  to  such  an  extent  in  some  cases  as  even  to 
threaten  life  very  seriously.  This  dangerous  shock  is  pro- 
duced even  when  the  patient  is  fully  etherized.  But  it  has 
been  found  that  if  a  solution  of  cocain  is  injected  into  the 


174  ANIMAL  EXPERIMENTATION 

nerves  supplying  the  arm  or  the  leg  above  the  point  at 
which  the  nerves  are  to  be  severed,  these  large  nerves  may- 
then  be  divided  with  impunity  and  without  the  least  shock, 
since  the  cocain  "blocks  "  the  sensory  impulses  going  to  the 
spinal  cord  and  brain  when  the  nerves  are  cut. 

Third,  spinal  anesthesia.  Lately  spinal  anesthesia  has 
attracted  great  attention,  and  has  been  widely  exploited 
by  the  press,  and  many  inaccurate  notions  have  been  pub- 
lished. The  facts  are  as  follows :  From  the  initial  trials,  by 
Corning  in  America  in  1885,  there  has  been  developed  the 
method  which  we  now  know  as  spinal  anesthesia.  In  1891 
Quincke,  of  Kiel,  first  introduced  what  we  know  as  "  lumbar 
puncture  " ;  that  is  to  say,  the  introduction  of  a  long  hypo- 
dermic needle  between  the  vertebrae  into  the  sheath  which 
includes  the  nerves  at  the  lower  end  of  the  spinal  cord,  for 
the  purpose  of  withdrawing  some  of  the  cerebro-spinal  fluid 
which  surrounds  the  spinal  cord  and  is  continuous  with  that 
within  the  skull.  The  object  that  Quincke  had  in  view  was 
that  of  diagnosis.  By  this  procedure,  now  constantly  used, 
we  are  able  to  determine  whether,  in  cases  of  brain  tumors 
and  some  other  conditions,  this  fluid  exists  under  a  higher 
pressure  than  is  normal;  whether  the  fluid  contains  blood, 
and  therefore  indicates  hemorrhage  either  around  the 
spinal  cord  or  even  within  the  skull;  and  again,  by  micro- 
scopic and  bacteriological  examination,  whether  the  fluid 
contains  any  bacteria  which  are  capable  of  producing  dis- 
ease. This  has  now  become  a  well-established  method  of 
investigating  and  diagnosticating  a  number  of  diseases,  the 
most  noteworthy,  perhaps,  being  cerebro-spinal  and  tuber- 
culous meningitis.  From  the  use  of  the  method  for  diag- 
nosis, however,  it  was  a  very  easy  step  to  treatment,  for  by 
the  same  needle  by  which  one  withdraws  the  cerebro-spinal 
fluid  it  would  be  possible  to  inject  various  remedies.  Thus 
the  mortality  of  cerebro-spinal  meningitis  has  been  dimin- 
ished from  sixty  per  cent  or  even  ninety  per  cent  down  to 
twenty-five  per  cent  or  less  by  the  injection  of  the  serum 


AND  MEDICAL  PROGRESS  175 

discovered  by  Flexner  and  Jobling  at  the  Rockefeller 
Institute. 

Naturally  one  of  the  obvious  questions  would  be  whether 
the  injection  of  cocain  directly  into  the  sheath  of  the  spinal 
cord,  thus  bringing  it  into  direct  contact  with  the  nerves 
from  the  cord,  would  not  produce  anesthesia  of  all  the  body 
below  the  point  of  injection.  The  answer  given  by  experi- 
mental research  was  that  it  would. 

Spinal  anesthesia  has  now  reached  a  stage  of  practical 
utility.  The  injection  is  made  into  the  lumbar  region  (the 
small  of  the  back)  between  the  vertebrae.  Cocain  now  is 
rarely  used,  because  of  its  danger.  Stovain  was  used  for  a 
considerable  time.  Since  then  novocain  and  tropacocain 
have  replaced  it,  as  they  are  found  to  be  much  less  dan- 
gerous. 

Recently  Jonnesco  has  advocated  applying  this  method 
even  as  high  as  between  the  shoulders,  and  has  thought 
that  the  danger  of  stovain  was  much  diminished  by  the 
addition  of  a  small  amount  of  strychnin  to  the  stovain. 
But  experience  in  a  large  number  of  cases  has  shown  that 
Jonnesco's  method  is  far  from  being  devoid  of  danger. 

One  can  easily  understand  that  there  are  dangers  pecu- 
liar to  this  method  of  anesthesia.  A  tubular  needle  is  a 
very  difficult  thing  to  disinfect  thoroughly,  and  infection  of 
the  cerebro-spinal  fluid  would  be  a  very  serious  danger.  In 
some  cases  the  needle  itself  has  broken  off,  requiring  a  seri- 
ous operation  to  remove  the  broken  point.  Palsy  of  the 
lower  extremities  and,  curiously  enough,  palsy  of  the  mus- 
cles of  the  eye  have  followed  in  a  few  cases.  But  the  chief 
danger  is  that  of  collapse,  and  especially  failure  of  the 
respiration.  The  nervous  center  which  governs  breathing  is 
situated  in  the  spinal  cord  immediately  below  the  base  of 
the  skull.  The  cerebro-spinal  fluid,  as  a  rule,  circulates 
freely  up  and  down  around  the  spinal  cord  and  into  the 
cavity  of  the  skull.  With  the  patient  lying  down,  and  es- 
pecially if  the  shoulders  and  head  are  lower  than  the  rest 


176  ANIMAL  EXPERIMENTATION 

of  the  body,  the  solution  of  stovain  or  cocain,  etc.,  gravi- 
tates toward  this  respiratory  center,  and  when  the  drug 
reaches  this  center  and  anesthetizes  it,  it  may  easily  pro- 
duce collapse  and  failure  of  the  respiration,  which  are  very 
serious  dangers.  Even  in  Jonnesco's  own  hands,  in  several 
cases  operated  on  recently  in  this  country,  death  was  only 
averted  by  the  prolonged  use  of  artificial  respiration. 

In  view  of  all  these  possible  dangers  and  complications, 
prudent  surgeons  restrict  the  use  of  spinal  anesthesia  in  two 
ways:  (1)  They  are  unwilhng  to  inject  it  at  a  point  above 
the  small  of  the  back  (i.e.,  the  lumbar  region)  for  fear  that 
it  may  reach  the  respiratory  center,  and  (2)  they  limit  its 
use  to  the  exceptional  cases  in  which  the  use  of  ether,  chlo- 
roform, or  nitrous  oxid  is  attended  with  unusual  danger,  and 
therefore  contra-indicated.  Within  this  limited  field  spinal 
anesthesia  has  a  distinct  value.  Beyond  this  field  it  may 
hereafter  be  made  less  dangerous  and  therefore  more  widely 
applicable,  but  that  can  only  be  as  a  result  of  further  ex- 
periment and  observation. 

Alluring  as  it  unquestionably  is  to  be  able  to  have  an 
operation  performed  on  one's  seK  without  the  loss  of  con- 
sciousness —  a  condition  to  which  there  is  often  a  very 
natural  repugnance  —  the  preservation  of  consciousness 
during  an  operation  is  a  distinct  disadvantage  in  most 
cases.  As  I  said  in  1907,  "  to  have  the  patient  aware  of  sur- 
gical emergencies,  which  frequently  arise  and  which  often 
test  a  veteran  operator's  skill  and  resources  to  the  utmost, 
would  frequently  invite  death  by  the  terror  which  it  might 
occasion.  Even  the  usual  emergencies  of  hemorrhage, 
etc.,  which  attend  almost  every  operation  and  which  are 
easily  conquered  by  the  surgeon,  would  frighten  most 
patients.  The  ideal  anesthetic,  hereafter  undoubtedly  to  be 
discovered  by  experimental  research,  will  abolish  pain  by 
the  abolition  of  consciousness,  hut  without  danger  to  life  J' 


AND  MEDICAL  PROGRESS  177 

Surgery  of  the  Nerves 

I  have  already  alluded  above  to  the  blocking  of  sensation 
in  nerves  in  cases  of  amputation  by  the  injection  of  a  local 
anesthetic  directly  into  the  tissue  of  the  nerve.  Twenty 
years  ago  operations  on  nerves  were  very  few.  At  present 
they  are  constantly  performed.  As  long  ago  as  1863  Phil- 
lipeaux  and  Vulpian  by  experiments  upon  animals  proved 
that  by  uniting  nerves  which  had  been  divided  the  function 
of  the  nerve  might  be  reestablished.  Until  these  experi- 
ments had  proved  it,  there  would  be  a  natural  fear  that  if 
we  sewed  the  two  ends  of  a  severed  nerve  together,  the 
needle  puncture  and  the  thread,  which  must  remain  in  the 
nerve  for  a  considerable  time,  might  inflict  serious  or  even 
lasting  injury.  Indeed,  it  was  supposed  at  that  time  that 
very  possibly  lockjaw  might  follow;  for  that  lockjaw  was 
only  caused  by  a  special  germ  was  then  unknown.  It  has 
been  proved,  however,  on  animals,  that  these  supposed 
dangers  did  not  follow,  but  that  severed  nerves  could  be 
sewed  together  without  harm.  In  case  a  patient  in  falling 
puts  his  arm  through  a  pane  of  glass  and  the  broken  glass 
divides  the  sinews  (tendons)  and  the  nerves  at  the  wrist, 
where  they  lie  just  under  the  skin,  in  view  of  our  present 
knowledge  it  is  the  bounden  duty  of  the  surgeon  who  first 
sees  the  case  to  sew  the  divided  sinews  end  to  end,  and, 
what  is  quite  as  important,  if  not  more  so,  to  sew  the  di- 
vided nerve  ends  together  in  order  to  avoid  permanent 
paralysis.  If  this  is  done  promptly,  success  is  almost  the 
rule.  Even  if  this  has  not  been  done  and  the  severed  nerve 
has  remained  ununited  for  weeks,  months,  or  in  some  cases 
for  years,  it  is  possible  in  not  a  few  cases  to  restore  the 
function  of  the  nerve  and  cure  the  paralysis  by  sewing  the 
ends  together. 

One  nerve  in  the  arm,  the  musculo-spiral,  so  called  be- 
cause it  winds  among  the  muscles  in  a  spiral  fashion  around 
the  upper  arm  bone,  is  peculiarly  liable  to  injury,  for  in- 


178  ANIMAL  EXPERIMENTATION 

stance,  by  a  stab  wound  by  a  pocket-knife  or  a  gunshot 
wound.  But  the  most  frequent  source  of  injury  to  this 
nerve  as  it  winds  around  the  bone  itself  is  fracture  <.?>f  the 
arm  bone  about  midway  between  the  elbow  and  the  shoul- 
der. In  some  cases  the  nerve  is  torn  to  such  an  extent  that 
the  two  ends  when  they  are  dissected  loose  at  operation  are 
separated  by  a  considerable  interval.  If  this  interval  is  not 
too  large,  by  stretching  the  nerve  above  and  below  the 
point  of  injury  we  can  bring  the  ends  into  contact  and  sew 
them  together.  In  other  cases,  however,  the  gap  between 
the  two  ends  is  too  wide  for  approximation  of  the  two  ends. 
In  this  condition  there  are  various  ways  of  accomplishing 
union  of  the  nerve.  Among  them,  in  a  number  of  cases, 
surgeons  have  deliberately  laid  bare  the  bone,  sawed  out  an 
inch  or  more  of  the  bone,  and  wired  the  ends  of  the  bone 
together.  This  shortens  the  upper  arm  to  such  an  extent 
that,  with  stretching,  the  two  nerve  ends  can  be  brought 
into  contact  and  held  in  this  position  by  sewing  them  to- 
gether; after  the  wound  is  dressed  splints  are  then  applied 
to  the  arm  as  in  any  ordinary  fracture.  This  operation, 
especially  if  done  early  enough,  is  followed  by  a  consider- 
able, and  in  some  cases  practically  a  perfect,  recovery  of 
function  —  a  useless  arm  is  made  useful  again. 

The  bundle  of  nerves  which  originate  from  the  spinal 
cord  in  the  neck  and  are  distributed  to  the  arm  are  also 
specially  liable  to  injury.  Occasionally,  in  fracture  of  the 
collar  bone,  these  nerves  are  seriously  injured.  In  other 
cases,  by  a  fall  on  the  shoulder  —  for  instance,  from  a 
bicycle  —  one  or  more  of  these  nerves  are  completely  torn 
across.  This  is  the  condition  which  we  now  know  occurs  in 
a  great  many  cases  of  the  so-called  "birth  palsies,"  in  which 
one  arm  from  the  time  of  birth  hangs  flabby  and  useless. 
Unless  the  condition  is  remedied,  it  means  a  useless  arm 
during  the  entire  life  of  the  patient.  Only  within  the  last 
few  years  has  this  condition  been  recognized  as  due  to  rup- 
ture of  the  nerves,  and  attempts  have  been  made  to  remedy 


AND  MEDICAL  PROGRESS  179 

the  serious  disability  following  the  injury.  The  nerves  have 
been  exposed,  and  where  they  have  been  torn  apart  the 
ends  have  been  sewed  together  with  the  very  gratifying 
result  in  a  number  of  cases  of  a  partial  or,  in  some  cases, 
practically  of  complete  restoration  of  function  of  the  arm. 

Of  course  in  all  of  these  cases  of  wound  or  other  injury, 
as  a  rule,  the  earlier  the  operation  is  done  the  greater  the 
prospect  of  success,  but  in  a  number  of  cases  not  only  sev- 
eral months  but  sometimes  years  have  elapsed  before  the 
operation  has  been  performed,  and  yet  restoration  of  func- 
tion has  followed.  After  the  operation,  subsequent  treat- 
ment by  massage  and  the  use  of  the  various  electrical  cur- 
rents are  quite  as  important  as  the  operation  itself,  and 
should  be  persisted  in  for  a  year  or  even  two  years  before 
giving  up  all  hope  of  success. 

The  muscles  of  the  face  are  all  supplied  by  what  we  know 
as  the  seventh  or  facial  nerve.  This  comes  through  a  canal 
in  the  base  of  the  skull  very  close  to  the  mastoid  process 
(the  bony  lump  behind  the  ear),  emerges  from  the  bone 
just  behind  the  lobe  of  the  ear,  and  then  spreads  out  fanlike 
over  the  face,  supplying  all  of  its  muscles.  A  stab  wound 
or  gunshot  wound  just  below  or  just  in  front  of  the  ear  not 
uncommonly  paralyzes  one  side  of  the  face  by  destroying 
this  nerve  trunk.  Occasionally,  imavoidably,  in  the  well- 
known  mastoid  operation  for  ear  disease,  the  same  nerve 
is  injured.  Only  within  fifteen  years,  by  a  happy  thought, 
first,  Ballance,  of  London,  then  Kennedy,  of  Glasgow,  Bar- 
denhauer,  of  Cologne,  and  a  number  of  surgeons  in  America 
and  elsewhere,  have  treated  this  condition  surgically,  and 
the  unsightliness  of  a  face  with  the  usual  expression  on  one 
side,  but  motionless  and  expressionless  on  the  other,  has 
been  remedied.  This  relief  has  been  made  possible  in  con- 
sequence of  the  studies  of  the  union  of  divided  nerves  in 
animals  and  the  means  of  their  regeneration  —  i.e.,  restora- 
tion to  their  normal  power. 

In  the  neighborhood  of  the  facial  nerve  run  two  other 


180  ANIMAL  EXPERIMENTATION 

nerves  of  about  equal  size;  one  (the  hypoglossal)  going  to 
the  tongue;  the  other  (the  spinal  accessory)  going  to  certain 
muscles  of  the  neck.  In  cases  in  which  the  destruction  of 
the  facial  nerve  has  been  so  extensive  that  the  two  ends 
could  not  be  united,  one  of  these  two  uninjured  nerves  just 
mentioned  is  partly  or  completely  divided,  and  the  end  of 
the  facial  nerve  which  goes  to  the  muscles  of  the  face 
hitched  on  to  the  facial  or  hypoglossal  nerve.  In  quite  a 
number  of  cases  the  face  has  recovered  its  expression  and 
the  muscles  their  ability  to  contract. 

Surgery  of  the  Chest 

The  surgery  of  the  great  cavities  of  the  body  —  i.e.,  of 
the  head,  of  the  chest,  and  of  the  abdomen  —  has  advanced 
at  very  different  rates  of  progress.  The  surgery  of  the  abdo- 
men was  the  first  of  these  three  regions  to  show  immense 
progress  as  a  result  of  the  introduction  of  anesthesia,  anti- 
sepsis, and  experiment.  Only  a  little  over  twenty  years  ago 
did  the  surgery  of  the  head  begin  to  make  any  serious  prog- 
ress. The  surgery  of  the  chest,  until  within  the  last  very- 
few  years,  has  been  almost  at  a  standstill.  One  reason  for 
this  is  the  character  of  the  contents  of  the  chest.  They  are, 
the  esophagus  on  its  way  from  the  mouth  to  the  stomach; 
the  lungs  covered  by  the  pleura;  the  heart  in  its  sac  (the 
pericardium) ;  and  the  enormous  blood-vessels,  some  con- 
veying the  blood  from  the  heart  to  all  parts  of  the  body  by 
the  arteries  (the  aorta  and  its  branches),  some  bringing  it 
back  to  the  heart  by  the  great  veins  (forming  the  greater 
circulation),  and  others  going  from  the  heart  to  the  lungs 
and  coming  back  to  the  heart  from  the  lungs  (the  lesser  cir- 
culation). These  are  the  largest  blood-vessels  in  the  body; 
they  are  nearly  as  large  as  the  thumb,  and  any  interference 
with  them  is  so  dangerous  that  until  very  recently  it  has 
never  been  attempted. 

Moreover,  there  is  another  peculiar  feature  about  the 
chest  which  makes  it  very  dangerous  and  difficult  for  sur- 


AND  MEDICAL  PROGRESS:  181 

geons  to  operate  within  that  cavity.  The  chest,  by  means 
of  the  motion  of  the  ribs  and  the  diaphragm,  practically 
acts  like  a  bellows,  drawing  the  air  into  the  lungs  through 
the  mouth  and  nose  (corresponding  to  the  nozzle)  when  the 
diaphragm  descends  and  the  ribs  rise,  and  expelling  the  air 
in  the  reverse  way  when  the  diaphragm  and  the  ribs  reverse 
their  action.  If  one  made  an  opening  in  the  chest  wall,  it 
was  like  making  an  opening  in  the  side  of  a  pair  of  bellows, 
but  with  one  serious  difference.  The  air  would  rush  into  the 
cavity  of  the  chest  through  this  artificial  opening,  would 
surround  the  lungs  in  the  pleural  cavity,  hut  would  not  get 
inside  the  lungs  to  aerate  the  bloody  and  the  lung  itseK  would 
collapse  because  suction  by  the  diaphragm  and  ribs  was  no 
longer  possible.  Moreover,  pleurisy  of  a  violent  and  often 
fatal  form  was  always  a  possibility.  And  yet  there  was  ur- 
gent need  for  remedial  surgery  in  this  region.  Patients, 
especially  children,  very  frequently  inhale  "foreign  bod- 
ies," which  pass  down  the  windpipe  into  the  great  bron- 
chial tubes,  going  each  to  its  respective  lung.  They  often 
lodge  so  far  down  as  to  be  inaccessible  through  the  mouth, 
or  even  through  an  opening  into  the  windpipe  (trach- 
eotomy). If  the  foreign  bodies  are  swallowed,  they  pass 
down  the  esophagus  and  may  be  arrested  at  any  level  in 
the  chest.  Then  again  frequently  pleurisy  passes  into  that 
form  in  which  a  large  amount  of  pus  (matter)  accumulates 
in  the  pleural  cavity  around  the  lung  and  should  be  evacu- 
ated. Abscesses  form  in  the  lungs  as  a  result  of  pneumonia 
or  of  other  causes.  Gangrene  of  the  lung  occasionally 
occurs.  In  consumption  great  cavities  are  formed  in  the 
lungs,  which  ought  to  be  drained  or  otherwise  dealt  with. 
Besides  all  these  there  are  gunshot  wounds,  stabs,  and  other 
accidental  injuries.  Yet  the  surgery  of  all  these  conditions 
was  in  the  most  backward  state  till  very  recently. 

At  the  meetings  of  the  American  Surgical  Association 
and  the  American  Medical  Association  in  1909,  several 
papers  were  read  dealing  with  the  surgery  of  the  chest,  such 


182  ANIMAL  EXPERIMENTATION 

as  sewing  up  the  lungs  when  they  have  been  wounded, 
removing  diseased  parts  of  lungs,  removing  large  portions 
of  the  wall  of  the  chest,  etc.,  with  extraordinary  ease,  com- 
pared with  a  few  years  before,  and  with  surprising  success. 

Urged  by  the  necessity  of  removing  foreign  bodies  that 
lay  in  the  bronchial  tubes,  various  experimenters  at- 
tempted to  reach  them  by  direct  operations  either  through 
the  chest  wall  from  in  front,  from  behind,  or  at  the  side  of 
the  chest.  Experiments  were  made  upon  lower  animals  to 
see  which  of  these  modes  of  approach  was  the  least  danger- 
ous, the  most  expeditious,  and  most  satisfactory,  but  all  of 
them  were  found  to  be  exceedingly  dangerous,  and  were 
only  resorted  to  when  the  dangers  of  not  doing  anything 
exceeded  the  dangers  of  attempting  to  do  something. 

Within  a  few  years,  however,  what  is  called  "broncho- 
scopy "  has  been  practiced  with  the  greatest  success.  TMien 
a  tack  or  other  foreign  body  has  been  inhaled,  we  now  can 
introduce  a  long  straight  tube  between  the  vocal  chords 
down  the  windpipe  to  the  point  where  the  windpipe  divides 
into  the  two  bronchi  to  the  right  and  left  lungs,  and  by 
means  of  powerful  electric  lights  can  then  see  the  foreign 
body,  and  can  even  pass  the  tube  into  the  right  or  the  left 
bronchus,  and  by  means  of  suitable  delicate  instruments 
passed  down  through  the  tube  can  seize  and  extract  this 
foreign  body.  This  is  a  vastly  less  dangerous  and  vastly 
more  successful  method  than  the  older  one  of  tracheotomy, 
but  as  yet  relatively  few  surgeons  are  masters  of  the 
method. 

When  the  foreign  body,  however,  is  beyond  the  reach 
even  of  such  an  instrument,  then  the  only  possible  way  to 
extract  it  is  through  the  lung  by  an  opening  in  the  chest.  In 
1904,  Sauerbruch  in  Breslau  constructed  an  air-tight  cham- 
ber from  which  the  air  could  be  exhausted  or  compressed 
to  any  extent.  Only  the  body  of  the  animal  was  placed  in 
the  chamber;  the  head  protruded  through  an  opening  with 
a  rubber  collar  around  the  neck  so  that  the  animal  could 


I 


AND  MEDICAL  PROGRESS  183 


be  etherized  from  the  outside.  Inside  the  chamber  there 
was  room  for  the  surgeon  and  his  assistants,  instruments, 
etc.  Control  of  the  amount  of  exhaustion  or  compression 
of  the  air  was  obtained  through  an  electric  motor  operated 
from  within  the  chamber,  and  a  telephone  gave  ready 
means  of  communicating  with  those  outside.  Various  mod- 
ifications of  this  have  been  made,  the  last  by  Dr.  Willy 
Meyer,  of  New  York.  He  has  shown  that  the  pressure 
of  the  atmosphere  as  indicated  by  the  barometer  in  New 
York  varies  normally  between  that  at  sea-level  and  that 
which  corresponds  to  an  elevation  of  one  thousand  seven 
hundred  to  two  thousand  feet;  but  in  the  chamber  he 
has  devised  to  open  the  chest  safely  it  is  only  necessary 
to  exhaust  the  air  to  what  corresponds  to  an  elevation 
of  two  hundred  and  fifty  or  three  hundred  feet,  about  the 
height  of  many  modem  "sky-scrapers."  In  this  chamber 
he  has  removed  part  or  all  of  one  lung  in  twenty-six  dogs, 
with  twenty-two  recoveries  —  84.6  per  cent. 

Last  year,  also,  Meltzer  and  Auer  at  the  Rockefeller 
Institute  devised  still  another  method  of  respiration  that 
may  possibly  render  even  such  a  chamber  in  many  cases 
unnecessary.  By  "ventilating  the  lungs,"  or  "tracheal 
insufflation"  as  it  has  been  called  —  i.e.,  by  introducing  a 
tube  into  the  windpipe  and  forcing  a  gentle  current  of  air 
charged  with  a  certain  amount  of  ether  vapor  into  the 
lungs  —  they  have  found  that  all  the  necessary  respiratory 
changes  of  oxygen,  carbonic  acid,  etc.,  go  on,  and  the  ani- 
mal can  be  kept  alive  for  hours  without  any  movement 
v)hatever  of  the  chest  in  breathing.  Utilizing  this  method. 
Carrel  has  done  some  extraordinary  work  on  the  aorta,  the 
great  blood-vessel  which  carries  all  the  blood  from  the  heart 
to  the  entire  body  and  in  man  is  as  large  as  the  thumb.  He 
has  divided  it  at  different  levels,  clamping  the  aorta  above 
and  below  the  point  of  division  to  prevent  hemorrhage, 
long  enough  to  sew  the  ends  together,  has  incised  and  even 
cut  away  portions  of  the  aorta,  and  done  other  remarkable 


184  ANIMAL  EXPERIMENTATION 

surgical  operations,  from  which  the  animals  in  most  of  the 
eases  reported  recovered. 

In  February  last  I  saw  him  thus  freely  open  the  entire 
chest  from  side  to  side,  operate  upon  the  aorta,  and  man- 
ipulate heart,  lungs,  and  other  organs  in  the  chest  with  the 
same  facihty  and  safety  as  we  handle  the  various  organs 
in  the  abdomen.  The  operation  lasted  an  hour  and  a  half, 
and  an  hour  later  the  dog  had  entirely  recovered  from  the 
ether,  and  was  doing  better  than  a  human  being  after  most 
capital  operations. 

Thus  a  wholly  new  chapter  in  the  sui^ery  of  the  chest 
and  its  great  blood-vessels  has  been  opened. 

These  advances  in  the  surgery  of  the  chest  in  animals 
will  lead  quickly  to  very  great  advances  in  the  surgery  of 
the  chest  and  its  contained  organs,  the  heart,  the  lungs, 
the  esophagus,  and  even  the  aorta,  in  man.  In  fact,  already 
more  than  a  score  of  cases  have  been  operated  on,  usually 
in  a  Sauerbruch  chamber.  A  most  extraordinary  case  was 
reported  at  the  German  Surgical  Congress  in  April,  1909, 
by  Von  Eiselsberg,  of  Vienna.  A  man  stabbled  himself 
repeatedly  in  the  chest  with  a  pair  of  sharp  scissors.  He 
was  brought  to  the  hospital  and  operated  upon  in  a  Sauer- 
bruch chamber  within  an  hour  after  the  accident.  He  was 
already  unconscious,  so  that  no  anesthetic  was  needed, 
was  pulseless  —  in  fact,  was  dying.  The  chest  was  opened 
widely,  the  lungs  drawn  aside;  the  heart  and  its  great 
blood-vessels  could  be  readily  seen  and  manipulated.  It 
was  discovered  that  the  scissors  had  made  a  considerable 
rent  in  one  of  the  great  blood-vessels  carrying  the  blood 
between  the  heart  and  the  limgs.  This  was  sewed  up  with 
six  stitches,  and  the  man  survived  for  fifty -four  days  — 
almost  eight  weeks.  This  is  the  first  operation  on  man  of 
this  kind  ever  recorded.  Had  the  operation  been  done 
deliberately,  with  all  the  necessary  antiseptic  precautions, 
there  is  little  doubt  that  the  man  would  have  survived; 
but  when  life  is  ebbing  away  with  the  lapse  of  every 


AND  MEDICAL  PROGRESS  185 

moment,  one  is  between  the  Scylla  of  too  great  haste  and 
therefore  possible  infection,  and  the  Charybdis  of  too  great 
delay  for  proper  disinfection  while  the  patient  is  dying  from 
hemorrhage. 

Occasionally  the  blood  suddenly  forms  a  clot  in  the 
great  artery  carrying  the  blood  from  the  heart  to  the  lungs, 
thus  arresting  more  or  less  completely  the  aeration  of  the 
blood.  This  accident  is  necessarily  fatal,  sometimes  so 
quickly  that  nothing  can  be  done.  But  in  most  of  the  cases 
death  does  not  follow  for  fifteen  to  forty  minutes,  and  occa- 
sionally for  an  hour  or  more.  After  experiments  upon 
animals,  which  he  reported  in  1907,  Trendelenburg,  of 
Leipzig,  believed  it  to  be  possible  to  rescue  some  of  these 
relatively  slow-dying  cases.  The  next  year  one  of  his 
patients,  a  woman  of  seventy,  suddenly  collapsed,  and  was 
evidently  dying.  Fortunately  he  lived  only  eight  minutes 
away.  He  was  called  by  telephone,  and  in  eighteen  minutes 
after  the  first  symptom  the  operation  was  begun,  and  in 
five  minutes  more  the  chest  had  been  opened,  the  artery 
exposed  and  opened,  and  the  clots  removed.  This  was  the 
first  case  of  this  kind  ever  operated  upon.  But  the  patient 
was  too  old  and  too  far  gone  for  recovery. 

The  second  operation  was  done  by  Trendelenburg's 
assistant,  this  patient  living  for  fifteen  hours.  Kruger  has 
recently  reported  a  third  case,  who  lived  for  five  and  a 
quarter  days. 

With  constantly  improving  technic,  success  is  sure  to 
follow  before  long,  just  as  it  has  followed  many  early 
failures  in  operations  for  typhoid  perforation,  goiter,  cancer 
of  the  stomach,  and  many  other  operations.  Thus  from 
1849  to  1875  the  stomach  had  been  operated  on  for  cancer 
twenty-eight  times  with  twenty-eight  deaths.  The  twenty- 
ninth  case,  in  1875,  was  successful.  The  operation  has 
gradually  become  more  and  more  successful  as  our  technic 
has  improved,  till  now  the  great  majority  of  the  patients 
recover. 


186  ANIMAL  EXPERIMENTATION 

That  valvular  disease  of  the  heart  may  in  time  come 
within  the  domain  of  surgery  I  have  little  doubt. 

Some  cases  of  cancer  of  the  esophagus,  also,  heretofore 
absolutely  abandoned  to  death,  have  been  operated  on, 
but  with  only  fair  success  thus  far.^ 

Ulcer  and  Cancer  of  the  Stomach 

To  attempt  to  give  any  idea  of  the  advances  made  in  the 
surgery  of  the  various  organs  contained  in  the  abdomen  in 
the  short  space  at  my  disposal  is  hopeless.  I  can  only 
consider  a  few  special  points. 

Among  the  most  important  are  ulcer  and  cancer  of  the 
stomach.  It  is  now  well  established  that  most  cases  of 
cancer  of  the  stomach  originate  from  a  chronic  ulcer.  This 
ulcer  has  two  distinct  dangers  besides  that  of  a  possible 
cancerous  degeneration.  Not  seldom  the  ulcer  eats  into 
one  of  the  large  blood-vessels,  just  as  in  consumption  the 
same  process  in  the  lung  opens  one  of  the  large  blood-vessels 
of  the  lung.  In  either  case  a  more  or  less  profuse  and  always 
dangerous  hemorrhage  takes  place. 

In  cases  of  chronic  trouble  with  the  stomach,  surgeons 
are  not  now  disposed  to  wait  until  a  profuse  hemorrhage 
announces  the  presence  of  an  ulcer,  but  they  open  the 
abdomen  and  then  open  the  stomach,  search  for  the  ulcer 
and  treat  it.  This  avoids  or  remedies,  as  the  case  may  be, 
not  only  hemorrhage,  which  is  so  dangerous,  but  another 
danger,  namely,  that  the  ulcer  will  eat  its  way  entirely 
through  the  wall  of  the  stomach  and  suddenly  allow  the 
contents  of  the  stomach  to  escape  into  the  general  cavity 
of  the  abdomen.  This  is  invariably  followed  by  a  fatal 
peritonitis  unless  operation  is  undertaken  at  once.  The 
number  of  cases  in  which,  after  such  a  perforation,  opera- 
tion has  been  done  is  now  very  large,  and  when  it  is  done 

'  ^  See  the  paper  on  "The  Influence  of  Antivivisection  on  Character" 
(p.  234)  for  a  later  and  fuller  account  of  the  recent  progress  on  the  surgery 
of  the  chest  by  means  of  experiments  upon  animals. , 


AND  MEDICAL  PROGRESS  187 

promptly,  within  say  a  few  hours,  the  percentage  of  recov- 
eries is  very  large. 

Cancer  is  very  apt  to  attack  the  stomach  at  the  orifice  of 
exit  called  the  pylorus,  where  the  food  passes  into  the  upper 
intestine.  When  cancer  develops  here,  this  opening  is  grad- 
ually narrowed  until  no  food  can  escape  from  the  stomach. 
All  that  the  patient  swallows  remains  in  the  stomach, 
undergoes  decomposition,  and  creates  the  greatest  possible 
distress  in  addition  to  the  pain  of  the  cancer.  In  these 
cases,  if  we  cannot  remove  the  cancer,  we  make  an  opening 
in  the  stomach  and  an  opening  in  a  nearby  loop  of  the  upper 
bowel,  sew  the  two  openings  together,  and  in  that  manner 
side-track  the  food  past  the  obstruction  precisely  as  the 
Welland  Canal  passes  aroimd  the  obstruction  to  naviga- 
tion by  Niagara  Falls. 

If  we  could  only  make  a  diagnosis  of  cancer  in  the  very 
earliest  stages,  it  would  be  possible  in  most  cases  to  remove 
the  cancer  and  have  patients  recover.  In  a  very  consider- 
able number  of  cases  parts,  and  in  a  few  cases  all  of  the 
stomach  have  been  removed,  the  esophagus  and  the  intes- 
tines have  been  sewed  together,  and  while  many  of  the 
patients  have  died,  a  number  have  recovered  and  lived  for 
months  and  in  some  cases  for  a  much  longer  period.  In  the 
past  few  years  the  percentage  of  recoveries  has  increased 
very  encouragingly. 

The  diflSculty  is  in  making  a  diagnosis  before  the  disease 
has  advanced  to  the  stage  when,  by  adhesions  to  neighboring 
organs  and  infection  of  the  glands,  removal  of  the  cancer  with 
any  hope  of  permanent  success  is  practically  past.  When  a 
case  of  marked  indigestion  has  been  rebellious  for  a  num- 
ber of  weeks,  surgeons  are  more  and  more  inclined  to  open 
the  abdomen  and  by  actual  inspection  and  palpitation  of 
the  stomach  to  determine  whether  it  is  cancerous  or  not. 
In  these  early  stages  the  removal  of  the  cancer  is  not  an 
extremely  dangerous  operation.  Such  an  "exploratory" 
operation  is  fully  justified,  for  if  no  cancer  exists,  prac- 


188  ANIMAL  EXPERIMENTATION 

tically  all  of  the  patients  recover,  and  not  seldom  the 
surgeon,  even  if  he  finds  no  cancer,  does  find  adhesions, 
ulcer,  or  other  difficulty  which  can  be  remedied.  Ulcer 
precedes  cancer  in  about  two  cases  out  of  three,  and  prob- 
ably even  more;  perforation  of  the  stomach  by  an  ulcer 
occurs  in  about  one  case  in  five.  The  average  of  recoveries 
after  perforation,  if  operated  on  very  promptly,  is  about 
three  out  of  four;  later  it  is  reversed  —  three  out  of  four 
die  by  reason  of  the  delay. 

Surgery  of  the  Intestines 

Cancer  is  not  by  any  means  limited  to  the  stomach. 
It  not  uncommonly  attacks  the  intestine.  Here  again  an 
"exploratory"  operation  is  often  necessary.  If  we  can 
catch  the  disease  in  its  early  stages,  we  can  remove  large 
portions  of  the  intestine  and  by  various  devices  can  restore 
the  continuity  of  the  intestinal  canal  and  save  the  patient's 
life.  The  only  safety  for  the  sufferer  in  these  cases  lies  in 
early  operation.  When  operation  is  deferred,  we  are  almost 
sure  to  find  that  it  is  impossible  to  remove  the  disease,  and 
we  have  to  resort  again  to  the  device  above  spoken  of,  to 
side-track  the  intestinal  current  by  making  one  opening 
above  the  cancer  and  another  below  it  and  sewing  the  two 
openings  together.  As  in  the  similar  operation  between  the 
stomach  and  the  upper  bowel,  life  is  not  permanently 
saved,  for  the  cancer  remains,  but  life  is  prolonged  for 
months  and  sometimes  even  for  years,  and  the  immense 
comfort  that  is  given  to  the  patient  fully  justifies  the  pro- 
cedure, which  is  not  very  dangerous. 

In  not  a  few  cases  of  accident,  when,  for  example,  the 
wheel  of  a  wagon  runs  over  the  abdomen,  though  the 
abdominal  wall  may  not  be  ruptured,  rupture  of  the  intes- 
tine takes  place,  allowing  its  contents  to  escape  into  the 
general  abdominal  cavity.  So,  too,  when  a  stab  wound  or  a 
gunshot  wound  is  received,  a  similar  escape  of  intestinal 
contents  may  take  place.   In  these  cases,  where  the  evi- 


AND  MEDICAL  PROGRESS  189 

dence  from  the  symptoms  is  fairly  clear,  so  safe  is  abdom- 
inal surgery  in  these  antiseptic  days,  we  do  not  hesitate  to 
open  the  abdomen,  seek  for  the  point  of  rupture,  or  of  the 
wound,  and  either,  if  it  be  small,  sew  it  up  in  the  proper 
way,  or,  if  too  large  for  this  procedure  to  be  safe,  we  cut 
out  the  torn  portion  of  the  intestine  and  unite  the  two  ends. 
In  fact,  it  is  surprising  that  of  twenty-five  feet  of  the  intes- 
tine almost  one-half  has  been  successfully  removed.  In 
gunshot  wounds,  as  many  as  eighteen  perforations  have 
been  closed  and  the  patient  has  recovered. 

One  of  the  most  desperate,  frequent,  and  fatal  compli- 
cations of  typhoid  fever  is  perforation  of  the  bowel.  In 
typhoid  fever  ulcers  form  in  the  intestines,  and  in  a  large 
percentage  of  cases,  as  in  ulcer  of  the  stomach,  an  ulcer 
eats  into  a  blood-vessel,  producing  profuse  hemorrhage 
which  may  destroy  life,  or  if  it  eats  a  hole  entirely  through 
the  intestinal  wall,  the  deadly  intestinal  contents  then 
escape.  It  is  serious  enough  to  operate  on  a  healthy  patient 
who  has  had  a  hole  torn  in  his  intestine,  but  when  in  addi- 
tion to  the  perforation  we  have  to  operate  on  a  patient  who 
is  desperately  ill  with  typhoid  fever,  even  the  stoutest  heart 
might  well  shrink  from  it. 

The  first  operation  for  such  a  perforation  ever  done  was 
by  Mikulicz,  of  Breslau,  in  1884.  The  mortality  originally 
was  about  three  out  of  four.  Several  hundred  cases  oper- 
ated on  have  now  been  published,  and  the  mortality  has 
gradually  fallen  to  about  sixty-five  per  cent.  In  other  words, 
one  out  of  three  recovers  instead  of  one  out  of  four.  This 
seems  a  terrible  death-rate,  and  at  first  blush  one  might 
almost  believe  that  no  operation  ought  to  be  done  if  two 
out  of  three  or  three  out  of  four  die;  but  remember  the  alter- 
native —  if  no  operation  is  done,  practically  a  hundred  out 
of  every  hundred  die.  Operation,  therefore,  distinctly  saves 
every  case  that  recovers.  A  few  hospital  surgeons,  very 
favorably  situated  as  to  facilities,  have  been  so  fortunate 
as  to  save  about  one  half  of  the  cases  operated  on.    In 


190  ANIMAL  EXPERIMENTATION 

seventy  cases  of  operation  in  children  under  fifteen,  col- 
lected by  Jopson  and  Gittings,  there  were  only  thirty-one 
deaths  —  a  recovery  rate  of  fifty-six  per  cent.  With  speedy 
operation  (always  if  possible  within  a  few  hours)  and  suit- 
able methods,  the  next  few  years  will  undoubtedly  show  a 
general  mortality  of  only  fifty  per  cent  or  less,  and  every 
case  that  recovers  owes  his  Ufe  to  modern  antiseptic 
surgery. 

Heretofore,  in  searching  for  perforations  or  ruptures, 
surgeons  have  constantly  drawn  part  or  often  all  of  the 
intestines  temporarily  outside  of  the  abdominal  cavity, 
without  a  thought  that  the  patient  would  suffer  any  harm 
by  such  a  procedure.  We  used  no  especial  care  in  manipu- 
lating the  intestines,  particularly  when  haste  was  needful 
on  account  of  hemorrhage. 

But  Crile  has  studied  on  animals  the  deleterious  shock 
produced  by  any  rough  handhng  of  the  bowel  or  by  pres- 
sure upon  it,  and  Cannon,  of  Harvard,  has  recently  rein- 
forced Crile's  conclusions.  They  have  shown  that  mild, 
moderate,  or  rough  handling  of  the  bowel  (always  under  an 
anesthetic  of  course)  produces  very  pronounced  shock 
proportionate  to  the  roughness  of  such  handling. 

Hence  in  all  abdominal  operations  nowadays  —  e.g.,  for 
appendicitis,  etc.  —  surgeons  are  most  careful  to  handle 
the  intestines  with  the  greatest  gentleness,  and  never  dis- 
place them  outside  the  abdomen  if  it  can  possibly  be 
avoided,  with  the  result  that  the  mortality  of  abdominal 
surgery  is  always  steadily  decreasing. 

Surgery  of  the  Liver  and  Gall-Bladder 

The  liver  is  liable  to  stab  wounds,  gunshot  wounds,  and 
also  to  be  torn  when  a  patient  is  run  over  by  a  wagon,  cart, 
etc.  Besides  the  danger  of  infection  by  bullets,  dirks,  etc., 
which  is  very  great,  the  danger  of  death  from  hemorrhage 
always  exists.  Hence  if  there  is  good  reason  to  believe 
that  the  liver  has  been  wounded  or  torn,  the  abdomen 


AND  MEDICAL  PROGRESS  191 

should  be  opened  very  quickly,  the  hemorrhage  arrested, 
and  the  abdominal  (i.e.,  the  peritoneal)  cavity  cleansed. 
If  done  promptly,  a  very  large  percentage  of  the  patients 
recover.  To  show  how  in  this  as  in  other  operations  in- 
creasing experience,  by  disclosing  errors  and  establishing 
better  methods,  results  in  a  diminishing  rate  of  mortality, 
in  1887  the  mortahty  was  as  high  as  sixty-six  per  cent; 
in  operations  done  between  1895  and  1905  it  has  fallen  to 
forty-four  per  cent. 

Non-cancerous  tumors  of  the  hver  have  been  very  suc- 
cessfully removed  in  the  last  few  years,  sixty-three  out  of 
seventy-six  early  cases  having  recovered,  while  in  later 
cases  the  results  are  even  better.  Cancer  of  the  liver,  how- 
ever, is  practically  always  fatal. 

The  gall-bladder,  which  is  simply  a  receptacle  for  the 
bile,  has  now  been  successfully  removed  in  so  many  cases 
that  it  is  rather  puzzling  to  know  why  we  have  any  such 
organ.  The  bile  in  this  storage  reservoir  is  often  infected 
by  bacteria.  Such  an  infection  is  probably  the  rule  in 
typhoid  fever,  and  even  many  years  after  the  patient  has 
recovered  from  such  a  fever  the  bile  is  still  infected  and  not 
seldom  becomes  a  serious  menace  to  life.  In  addition  to 
other  causes,  typhoid  and  other  germs  frequently  cause 
gall-stones  to  form  in  the  gall-bladder.  These  are  concre- 
tions formed  from  the  solid  constituents  of  the  bile.  Often 
they  are  only  one,  two,  or  three  in  number,  but  in  some 
cases  they  number  hundreds  and  even  thousands  of  very 
small  stones.  Women  are  far  more  liable  to  gall-stone  dis- 
ease than  men  —  in  the  proportion  of  three  or  even  four  to 
one.  Tight  lacing  has  been  accused  of  being  one  of  the 
most  potent  causes. 

If  gall-stones  cause  trouble,  they  should  be  removed  by 
operation.  In  competent  hands  this  is  now  attended  with 
a  mortality  of  from  one  and  a  half  to  say  five  per  cent, 
depending  on  existing  complications. 


192  ANIMAL  EXPERIMENTATION 


Peritonitis 

Rupture  or  perforation  of  the  stomach  or  intestine,  from 
whatever  cause,  unless  speedily  operated  on,  always  sets 
up  a  general  peritonitis.  Until  within  the  last  few  years, 
when  this  diagnosis  was  made,  it  was  equivalent  to  a 
verdict  of  death.  Even  if  operation  was  done  the  patients 
almost  all  died.  But  in  the  last  few  years,  thanks  especially 
to  the  American  surgeons.  Murphy,  of  Chicago,  and  the 
late  Dr.  George  R.  Fowler  and  his  son.  Dr.  Russell  S. 
Fowler,  of  Brooklyn,  this  almost  hopeless  picture  has  been 
changed  to  one  of  great  encouragement.  It  is  needless  to 
enter  into  details  of  the  treatment*  but  it  may  be  sum- 
marized for  popular  knowledge  in  this  way:  It  has  been 
found  that  the  poison  of  pus  (matter)  in  the  abdomen  is 
much  more  readily  absorbed  in  the  upper  part  of  the  abdo- 
men next  the  diaphragm,  and  much  less  readily  absorbed 
in  the  lower  part  of  the  abdomen.  Hence  we  raise  our 
patients  suffering  from  peritonitis  in  bed,  sick  as  they  gen- 
erally are,  to  two  thirds  or  three  fourths  of  the  sitting 
position,  and  then  slowly  for  hours  flush  the  interior  of  the 
intestine  with  salt  solution  deUvered  very  gradually  but 
almost  continuously.  As  much  as  two  or  three  gallons  of 
the  salt  solution  may  be  absorbed  within  the  twenty-four 
hours.  At  the  present  time,  therefore,  even  when  the 
specter  of  general  peritonitis  is  present,  the  case  is  by  no 
means  hopeless,  but,  thanks  to  the  greatly  improved  treat- 
ment of  modern  days,  and  also  to  American  surgery,  it  is 
full  of  hope.* 

Hernia  or  Rupture 
One  of  the  commonest  surgical  conditions  in  the  human 

*  Dr.  R.  S.  Fowler  writes  me  that  by  this  method  and  by  earlier  oper- 
ating, his  mortality  has  gradually  fallen  from  thirty-eight  per  cent  to 
seven  per  cent  in  his  last  one  hundred  cases  as  against  about  seventy-five 
per  cent  before  this  treatment  was  adopted.  (1914.) 


AND  MEDICAL  PROGRESS  193 

body  is  hernia  or  rupture.  In  the  wall  of  the  abdomen 
there  are  a  few  openings  to  let  arteries  and  veins  and  other 
structures  pass  out  of  or  into  the  abdominal  cavity.  When 
these  apertures  —  or  "rings,"  as  we  call  them  —  are  not 
securely  closed  a  knuckle  of  bowel  often  protrudes  through 
the  opening.  This  is  a  hernia  or  rupture.  For  many  years 
after  I  graduated,  in  1862,  sporadic  attempts  were  made 
to  remedy  this  condition  by  operation,  so  as  to  spare  the 
patient  not  only  the  life-long  annoyance  of  a  truss,  but  the 
ever-present  danger  that  more  bowel  would  be  forced  sud- 
denly through  the  opening  in  the  wall  of  the  abdomen  as  a 
result  of  sudden  muscular  strain  in  lifting  something  heavy, 
and  become  gripped  by  the  opening,  or  what  we  know  in 
surgery  as  "strangulated";  that  is  to  say,  so  constricted 
that  gangrene  of  the  bowel  and  death  were  inevitable  unless 
relief  was  afforded. 

Until  the  antiseptic  method  was  thoroughly  grounded 
and  estabUshed  in  the  profession,  no  really  successful 
methods  to  cure  this  condition  had  been  devised,  for  the 
reason  that  until  the  advent  of  antisepsis  every  surgeon 
was  afraid,  and  rightly  afraid,  of  opening  the  abdominal 
cavity  on  account  of  the  exceedingly  great  danger,  or,  in 
fact,  almost  certainty  of  peritonitis.  About  twenty-five 
years  ago,  however,  attempts  began  to  be  made  to  remedy 
the  condition,  innumerable  new  methods  were  devised, 
imtil  finally  we  are  now  in  a  position  to  advise  almost  every 
sufferer  from  this  condition,  unless  too  old  or  suffering  from 
some  complication  which  would  make  it  undesirable,  to 
have  a  radical  operation  done.  How  little  danger  now  at- 
taches to  the  operation  is  seen  in  the  fact  that  in  a  series 
of  twenty-two  hundred  operations  by  Coley  there  have 
been  only  four  deaths.  Three  of  these  occurred  in  the 
twelve  hundred  children;  in  the  one  thousand  cases  in 
adults,  only  one  patient  died  —  a  mortality  of  only  one 
tenth  of  one  per  cent.  Well  did  Lord  Lister  at  the  Royal 
College  of  Surgeons  on  March  29,  1897,  say  of  a  similar 


194  ANIMAL  EXPERIMENTATION 

result:  "An  achievement  like  that  is  enough  to  cause 
gladness  in  the  heart  of  any  man  who  loves  his  fellow 
men." 

All  this  is  a  result  of  the  antiseptic  method,  which  in 
turn  is  the  result  of  animal  experimentation. 

Surgery  of  the  Pituitary  Body  or  Hypophysis 

About  at  the  crossing  of  two  lines,  one  drawn  horizon- 
tally backward  between  the  eyebrows,  and  the  other 
horizontally  across  between  the  temples,  is  a  cup-shaped 
depression  in  the  base  of  the  skull  a  little  smaller  than  the 
tip  end  of  the  Uttle  finger.  In  this  is  lodged  a  peculiar  gland 
or  body  called  the  hypophysis  or  pituitary  body.  It  is  one 
of  that  strange  class  of  "ductless  glands"  which  exist  in 
different  parts  of  the  body,  among  which  are  the  thymus 
gland  at  the  very  lowest  part  of  the  neck  in  front;  the 
thyroid  gland,  which  when  it  becomes  enlarged  is  called  a 
goiter;  the  parathyroid  bodies,  three  or  four  little  bodies, 
each  the  size  of  a  grain  of  wheat,  situated  behind  the  thy- 
roid; the  adrenal  or  suprarenal  bodies  at  the  upper  end  of 
each  kidney,  from  which  adrenaUn  is  derived,  and  several 
other  glands  which  have  no  tube  or  duct  which  can  deliver 
their  secretion  into  the  circulation.  The  "internal  secre- 
tions" which  they  are  believed  to  produce,  and  which 
reach  the  blood  current  through  the  absorbents,  formerly 
were  thought  to  be  of  no  importance,  but  now  we  know 
that  these  secretions,  in  some  cases  at  least,  are  of  supreme 
importance. 

If  in  animals  the  pituitary  gland  is  removed,  death  fol- 
lows in  the  course  of  a  short  time.  If  all  four  of  the  little 
parathyroids  are  removed,  death  takes  place  before  long. 
If  all  of  the  thyroid  is  removed,  we  have  a  condition  which 
gradually  develops  into  cretinism.  In  disease  of  the  adrenal 
gland  the  skin  becomes  of  a  bronze  color,  etc.,  and  disease 
of  the  thymus  frequently  results  in  sudden  death.  More- 


AND  MEDICAL  PROGRESS  195 

over,  the  pancreas  (which  in  animals  we  call  the  sweet- 
bread) may  be  involved,  and  through  that  in  turn  the 
liver,  so  that  this  whole  series  of  glands,  small  as  most  of 
them  are,  forms  a  most  complicated  system  which  we  have 
only  very  recently  begun  to  understand.  What  little  we 
have  learned  has  been  chiefly  by  animal  experimentation, 
and  this  little  emphasizes  the  need  for  more  and  more 
knowledge,  till  we  shall  know  thoroughly  their  functions, 
and  what  we  can  do  to  cure  or,  still  better,  to  prevent  their 
diseases. 

This  little  gland,  the  pituitary  body,  though  so  very 
small,  consists  of  a  front  and  a  back  part,  which  are  appar- 
ently wholly  different  in  fimction.  When  an  extract  of  the 
back  part,  which  is  supposed  to  be  the  most  active,  is 
injected  into  animals,  it  does  harm,  yet  when  the  same 
part  is  entirely  removed  from  the  brain  of  an  animal,  no 
harm  apparently  results.  The  front  half,  however,  has 
been  found  to  be  essential  to  life.  Certain  changes  in  the 
gland,  if  they  arise  in  childhood,  are  followed  by  tremen- 
dous overgrowth  of  the  body  (gigantism),  together  with  a 
deposit  of  much  fat  over  the  body.  If  the  condition  arises 
in  an  adult,  there  follows  clumsy  thickening  of  the  hands, 
feet,  features,  etc.  (acromegaly),  and  in  other  parts  of  the 
body  an  infantile  condition  is  produced. 

Surgery,  it  is  astonishing  to  say,  has  dealt  successfully 
with  tumors  of  this  small  but  important  organ  hidden  in  an 
almost  inaccessible  spot.  In  a  few  cases  such  tumors  have 
been  successfully  removed  in  man  with  great  relief,  if  not 
real  cure  of  the  symptons.^ 

Almost  the  same  story  may  be  told  of  all  the  other  duct- 

*  A  large  number  of  operations  have  been  done  —  one  hundred  and 
seven  by  Dr.  Harvey  Gushing  alone  with  only  eleven  deaths,  less  than  ten 
per  cent  (February,  1914).  The  results  have  been  most  encouraging, 
especially  the  restoration  of  sight,  if  the  operation  is  not  too  long  delayed. 
Strange  to  say,  its  extract  or  active  principle  has  been  found  to  be  of  the 
greatest  value  in  childbirth  —  an  unexpected  boon.  (See  the  British  Med- 
ical Journal,  April  25,  1904,  p.  90.) 


190  ANIMAL  EXPERIMENTATION 

less  glands  which  are  so  closely  interrelated.  Gradually, 
by  experiment  upon  animals,  we  are  learning  what  the 
functions  of  these  important  structures  are,  and  by  removal 
of  parts  or  all  of  these  glands,  or  by  other  experiments  upon 
them,  we  are  getting  a  gUmmering  knowledge  of  their 
interrelation,  their  importance,  and  the  possibility  of  deal- 
ing with  them  medically  and  surgically.  I  beheve  that  in 
the  near  future  our  ignorance  about  these  various  structures 
will  be  dispelled  and  the  surgery  of  these  glands  will 
develop  with  rapid  strides,  greatly  to  the  advantage  of 
many  patients. 

Tetanus  or  Lockjaw 

Among  the  many  other  subjects  crowding  upon  me  for 
description,  I  can  only  select  one  more  —  tetanus  or  lock- 
jaw. In  1884, 1  remember  my  surprise  and  almost  incredu- 
lity when  I  saw  it  asserted  that  Nicolaier,  by  experiments 
on  mice,  rabbits,  and  guinea-pigs,  had  discovered  that  the 
germ  or  bacillus  of  tetanus  was  found  in  the  earth,  and 
especially  in  that  around  stables  and  on  highroads  trav- 
eled by  horses.  It  was  such  a  novel  idea  that  I  was  little 
inclined  to  accept  this  as  a  possible  origin  of  lockjaw,  but 
time  has  proved  that  Nicolaier  was  right.  For  many  years 
we  had  known  clinically  that  stablemen,  above  all  others, 
suffered  from  lockjaw,  but  why  this  was  so  we  did  not 
understand.  Now  we  know  that  this  little  microbe 
finds  its  chief  abiding-place  in  and  around  stables,  high- 
roads, etc. 

The  popular  belief  that  a  wound  from  treading  on  a 
rusty  nail  is  very  likely  to  cause  tetanus  is  quite  correct. 
This  is  not  because  it  is  a  nail  or  is  rusty,  but  because  by 
lying  on  the  ground  it  has  become  infected  with  the  germs 
of  lockjaw.  Moreover,  as  the  punctured  wound  caused 
by  the  nail  bleeds  but  little  and  this  blood  dries  up  and 
excludes  the  air,  the  most  favorable  conditions  for  the 


AND  MEDICAL  PROGRESS  197 

development  of  tetanus  exist,  for,  as  Kitasato,  the  Japan- 
ese bacteriologist,  proved,  the  absence  of  oxygen  is  most 
favorable  to  the  growth  of  this  germ. 

The  germ  itself  looks  very  much  like  a  tack.  So  virulent 
is  it  that  its  toxin  in  doses  of  1 -200,000th  of  a  teaspoonful 
will  kill  a  mouse.  It  has  been  found  by  experiment  that  the 
poison  is  carried  up  to  the  spinal  cord,  not  by  the  absorb- 
ents or  the  blood-vessels,  as  are  other  poisons,  but  through 
the  motor  nerves  themselves.  Fortunately,  an  anti-poison 
or  antidote  has  been  developed,  but  so  prompt  is  the  action 
of  the  poison  that  in  an  animal,  two  minutes  after  the 
injection  of  a  fatal  dose  of  the  poison,  twice  as  much  of  the 
remedy  is  required  as  if  it  had  been  administered  with  the 
poison;  after  eight  minutes  ten  times  the  amount,  and  after 
ninety  minutes  forty  times  the  original  amount  is  neces- 
sary.  This  antitoxin  is  entirely  harmless. 

As  a  result  of  antiseptic  methods  lockjaw  is  now  almost 
unknown  except  after  neglected  wounds,  instead  of  being 
terribly  frequent  as  it  formerly  was.  When  it  is  feared,  the 
antitoxin  is  used  as  a  preventive,  and  when  it  has  devel- 
oped, as  a  cure. 

In  animals  —  for  naturally  horses  suffer  enormously 
more  frequently  than  man  —  the  same  antitoxin  is  used. 
In  one  hundred  and  sixty-three  horses  that  had  operations 
performed  on  them,  but  were  protected  by  the  antitoxin, 
not  one  developed  tetanus,  whereas  of  eight  cases  unpro- 
tected by  the  antitoxin,  five  developed  tetanus.  The  re- 
sult of  all  these  experiments  has  been  that  what  is  known 
as  "  Fourth-of  -  July  tetanus'*  has  been  enormously  dimin- 
ished, chiefly  by  the  antitoxin  used  as  a  preventive. 

It  is  well  known  now  to  every  intelligent  person  that  a 
large  number  of  cases  of  tetanus  develop  from  injuries, 
especially  those  received  from  toy  pistols  and  blank  car- 
tridges in  celebrating  the  Fourth  of  July.  The  following 
table  from  the  "Journal  of  the  American  Medical  Associa- 
tion" gives  the  number  of  persons  injured,  the  number  of 


198  ANIMAL  EXPERIMENTATION 

deaths,  and  the  number  of  deaths  from  tetanus  alone  for 
several  years  past:  — 

Deaths        Deaths  from 
Year  Injured  (total)  tetanus 

1903  4,449  466  406 


1904 

4,169 

183 

91 

1905 

5,176 

182 

87 

1906 

5,466 

158 

75 

1907 

4,413 

164 

62 

1908 

5,623 

163 

55 

1909 

5,307 

215 

125 

Totals 34,603  1,531  901 

The  popular  movement  for  a  "sane  Fourth  of  July" 
was  begun  by  the  doctors,  and  fortunately  is  spreading 
vigorously.  Too  long  we  have  had  an  "insane'*  Fourth 
with  its  thousands  of  victims.  Even  the  small  Chinese 
"fire-cracker"  has  caused  10,781  serious  injuries  in  the  last 
seven  years!  ^ 

^  The  splendid  results  of  this  campaign  —  conducted  above  all  by  doc- 
tors, mark  you  —  is  shown  by  the  fact  that  the  total  number  of  injuries 
over  the  entire  country,  which  was  5308  in  1896  was  only  947  in  1912;  and 
instead  of  415  deaths  from  lockjaw  alone  in  1903  there  were  but  seven  in 
1912  and  4  in  1913. 


MODERN    ANTISEPTIC    SURGERY    AND    THE 
ROLE  OF    EXPERIMENT    IN    ITS  DISCOVERY 
AND  DEVELOPMENT  1 

The  subject  naturally  divides  itself  into  three  parts: 
(1)  the  conditions  before  the  introduction  of  the  anti- 
septic method  by  Lister;  (2)  the  means  by  which  his 
system  was  discovered  and  developed,  and  (3)  the  condi- 
tions existing  after  the  introduction  of  the  method,  i.e., 
at  the  present  time. 

My  surgical  life  covers  all  three  of  these  periods  since  I 
graduated  in  medicine  in  1862,  some  years  before  Lister 
began  his  work.  I  have,  therefore,  fought  my  way  from 
the  horrors  of  the  preantiseptic  days  up  to  the  delights  of 
the  present  antiseptic  days.^ 

I,  The  Preantiseptic  Period 

In  my  early  surgical  experience  every  accidental  wound 
and  every  surgical  operation  (that  is,  an  intentional 
wound)  was  followed  by  inflammation  and  suppuration, 
i.e.,  the  discharge  of  "pus"  or  "matter."  This  was  not 
only  constantly  expected  as  an  unavoidable  process  of 
nature  and  believed  to  be  needful  for  healing,  but  was 
constantly  realized.  Hence  the  pus  was  called  "laudable" 
pus!  How  well  I  remember  forty  years  ago  at  the  begin- 
ning of  each  winter's  session  when  I  was  the  assistant  of  the 
late  Professor  Samuel  D.  Gross,  his  turning  to  the  orderly 
and  saying  to  him,  "To-morrow,  Hugh,  I  shall  lecture  on 

^  Reprinted  by  permission  of  the  Council  in  Defense  of  Medical  Re- 
search of  the  American  Medical  Association.  It  is  Pamphlet  No.  xii  in 
their  series.   See  list  on  p.  xix. 

'  In  this  article  I  use  the  word  " antiseptic"  as  the  more  popular  one  to 
include  also  the  aseptic  method. 


200  ANIMAL  EXPERIMENTATION 

suppuration.  Go  over  to  the  hospital  in  the  morning  and 
get  a  cupful  of  pus  for  my  lecture."  Pus,  mark  you,  was 
always  "on  tap,"  so  to  speak,  though  the  little  hospital 
contained  only  a  dozen  beds! 

Perhaps  the  best  way  to  give  the  reader  an  idea  of  wound 
conditions  at  that  time  will  be  to  describe  an  ordinary 
operation  and  its  results.  We  will  suppose  that  it  is  an 
amputation.  The  surgeon  approached  the  operation  with 
the  clean  hands  of  a  gentleman.  He  usually  wore  an  old 
coat  covered  with  dried  blood  spots  from  previous  service. 
His  finger-nails  very  likely  were  long  and  no  special  atten- 
tion was  given  to  them.  The  instruments  were  taken  out 
of  a  velvet-lined  case  and  were  as  clean  as  ordinary  table- 
knives  would  be.  The  operation  was  done  without  any 
preliminary  cleansing  of  the  skin  other  than  to  remove 
any  visible  dirt.  If  the  knife  happened  to  fall  on  the  floor 
it  was  picked  up,  rinsed  in  a  basin  of  ordinary  water,  and 
used  as  it  was.  The  marine  sponges  then  always  used  were 
washed  clean  in  ordinary  water  and  used  over  and  over 
again  even  after  being  saturated  with  foul  pus.  The  blood- 
vessels were  tied  with  ordinary  silk;  one  end  was  cut  short, 
the  other  one  hung  out  of  the  wound.  After  an  amputation 
of  a  fleshy  thigh  I  have  often  seen  twenty-five  or  thirty 
such  "ligatures,"  as  they  are  called,  gathered  into  two 
bimdles,  one  at  each  end  of  the  wound.  The  flaps  were  then 
sewed  together  with  an  ordinary  needle  and  thread  and  the 
stump  dressed  first  with  an  old  rag  (which,  however,  would 
be  ordinarily  clean)  or  scraped  lint  spread  with  some  simple 
grease.  Over  that  would  be  placed  some  other  rags,  lint, 
cotton,  or  other  dressing,  and  finally  a  bandage.  During 
the  Civil  War  these  greasy  dressings  gave  place  to  simple 
cold-water  dressings. 

By  the  second  day  the  patient  would  begin  to  have 
considerable  fever.  By  the  third  or  fourth  the  temperature 
would  rise  to  what  we  now  know  (for  medical  thermome- 
ters were  not  in  general  use  in  that  early  day!)  to  about 


AND  MEDICAL  PROGRESS  201 

103°,  104*^  or  105*^  F.  Then  we  would  poultice  the  wound. 
Every  few  hours  the  patient  would  be  disturbed,  a  new 
poultice  put  on  to  replace  the  old  one,  now  cold,  foul  and 
ill-smelling,  and  by  this  time  bathed  with  pus.  I  have 
often  seen  the  pus  escaping  by  the  tablespoonful  and  the 
wounds  alive  with  squirming  maggots  resembling  chestnut 
worms.  By  this  time  also  it  was  hoped  that  the  silk  liga- 
tures, with  which  the  arteries  had  been  tied,  had  literally 
"rotted"  loose,  and  each  one  of  them  was  gently  pulled  on 
to  the  discomfort  of  the  patient.  Care  was  taken  that  the 
ligatures  with  knots  tied  on  them  (in  order  to  distinguish 
those  that  secured  the  large  blood-vessels)  should  not  be 
pulled  on  severely  until  probably  the  tenth  or  twelfth  day. 
IVIeantime  the  patient  was  tossing  about  the  bed  with  pain, 
with  thirst,  without  appetite,  without  sleep  except  such  as 
morphin  would  secure.  This  drug  at  the  same  time  dried  up 
all  the  secretions,  producing  constipation  and  other  evils. 
By  about  the  tenth  to  the  fourteenth  day,  suppuration 
having  been  fully  established  and  quantities  of  pus  pouring 
from  the  wound,  the  fever  would  subside  and  the  wound 
would  begin  slowly  to  heal.  Of  course,  the  healing  could 
not  be  complete  so  long  as  the  silk  ligatures  were  still 
protruding  from  the  wound.  Sometimes  they  did  not 
become  detached  for  even  months  or  years,  but  more  com- 
monly all  of  them  would  rot  loose  in  from  ten  days  to  three 
weeks.  When  the  silk  ligatures  on  the  large  blood-vessels 
came  away,  if  the  healing  process  had  formed  in  the  blood- 
vessels a  firm  clot,  which  had  become  adherent,  and,  so  to 
speak,  "corked"  it  up,  all  went  well.  But,  as  very  fre- 
quently happened,  when  the  ligature  and  the  rotten  end 
of  the  artery  were  pulled  off  and  there  was  no  clot  to  act 
as  a  stopper,  " secondary ^  hemorrhage"  followed.  This 
often  came  on  after  the  patient's  wound  had  been  dressed 
and  the  surgeon  had  left,  and,  if  so,  very  likely  the  first 

1  So  called  to  distinguish  it  from  "primary  hemorrhage,"  i.e.,  the 
bleeding  occurring  at  time  of  the  accident  or  operation. 


202  ANIMAL  EXPERIMENTATION 

notice  that  the  nurse  had  that  anything  was  wrong  would 
either  be  the  gasping  for  breath  of  the  patient  or  his  moans 
and  cries,  or  sometimes  by  the  blood  which  had  not  only 
saturated  the  mattress,  but  had  even  appeared  in  a  pool 
on  the  floor.  How  fatal  were  such  hemorrhages  may  be 
seen  from  the  fact  that  in  2235  cases  of  hemorrhage  in  the 
Civil  War  61.7  per  cent  of  the  patients  died.* 

I  shall  never  forget  one  night  about  ten  days  after  the 
battle  of  Gettysburg,  when  it  was  my  business  as  "  oflBcer 
of  the  day"  to  attend  to  all  emergency  cases.  That  night 
I  was  called  to  five  cases  of  secondary  hemorrhage.  To 
indicate  what  a  difference  there  is  between  modern  and 
ancient  conditions,  in  the  thirty-four  years  since  October, 
1876,  when  I  began  the  practice  of  the  antiseptic  method, 
I  have  not  seen  as  many  cases  of  secondary  hemorrhage 
as  I  treated  in  that  one  night. 

It  was  a  rare  thing  for  any  patient  after  such  an  opera- 
tion to  get  well  under  three  or  four  weeks,  and  it  was 
not  uncommon  for  healing  to  be  delayed  for  three  or 
four  months,  so  that,  in  spite  of  the  great  mortality,  the 
wards  of  the  hospitals  were  cumbered  with  convalescent 
patients.  The  rare  case  in  which  healing  took  place  by 
"first  intention,"  i.e.,  at  once,  was  recounted  as  a  triumph. 
To-day  it  is  precisely  the  reverse.  The  case  in  which  heal- 
ing does  not  occur  primarily  and  at  once  is  regarded  as  a 
disaster. 

But  a  prolonged  convalescence  was  the  least  of  the 
evils  to  which  a  patient  was  subject.  A  large  majority  of 
the  wounds  were  followed  by  erysipelas,  by  lockjaw,  or  by 
blood  poisoning,  and  hospital  gangrene  sometimes  became 
a  veritable  plague.  Gangrene  in  various  forms  during  the 
Civil  War  was  rife  and  often  fatal.  In  2503  cases  1142 
patients  died,  a  mortality  of  45.6  per  cent.^  In  one  variety 
which  was  frequent,  hospital  gangrene,  a  simple  flesh 

*  Med.  and  Surg.  Hist.  War  of  the  Rebellion,  part  in,  Surg,  vol.,  p.  765. 
8  Ibid.,  p.  824. 


AND  MEDICAL  PROGRESS  203 

wound  scarcely  larger  than  the  bullet  which  made  it, 
became  larger  and  larger  till  a  hand  would  scarcely  cover 
it  and  it  would  eat  into  the  tissues  until  one  could  put  half 
his  fist  into  the  sloughing  cavity. 

Of  505  cases  of  lockjaw  (tetanus),  451  were  fatal,  a 
mortality  of  89.3  per  cent.^  Pyemia  or  blood  poisoning 
was  terribly  frequent  and  almost  as  fatal  as  it  was  frequent, 
for  of  2818  cases  in  the  Civil  War  2747  patients  died,  or 
97.4  per  cent  I  ^  When  a  joint  was  opened  or  wounded,  the 
result  was  frequently  either  amputation  or  death,  or  not 
uncommonly  amputation  and  death.  Of  2382  wounds  of 
the  knee-joint  alone  for  which  amputation  was  performed 
1212  patients  died,  a  mortality  of  51  per  cent,  and  of  973 
similar  wounds  for  which  amputation  was  not  performed 
591,  or  61  per  cent,  of  the  patients  died.^ 

Fractures,  as  most  people  know,  are  divided  into  two 
kinds:  simple  fractures  in  which  the  skin  is  unbroken, 
and  compound  fractures  in  which  the  broken  bone  pro- 
trudes through  the  skin.  Simple  fractures  nearly  always 
heal  with  relatively  little  pain  and  slight  fever;  but  in 
the  preantiseptic  days  when  the  skin  was  broken  and  the 
bone  protruded  two  out  of  three  patients  with  these 
compound  fractures  were  sure  to  die. 

Moreover,  certain  regions  of  the  body  were  forbidden 
ground  unless  the  surgeon  were  absolutely  compelled  to 
invade  them.  No  one  would  open  the  head  if  he  could 
possibly  avoid  it.  No  one  would  dare  to  make  an  incision 
through  the  abdominal  wall  into  the  cavity  of  the  abdomen 
unless  a  bullet  or  a  dirk  had  gone  before  him  and  opened 
the  way.  The  reason  for  our  hesitation  was  that  death 
stalked  behind  us. 

How  eloquent  is  the  statement  of  Sir  Samuel  Wilks,* 
that  "the  change  came  home  to  me  in  an  almost  startling 

*  Med.  and  Surg.  Hist.  War  of  the  Rebellion,  part  iii,  Surg,  vol.,  p.  819. 
2  Ibid.,  p.  858.  3  ifjid,^  p.  367, 

*  Royal  Com.  on  Vivisection,  1907-08,  Q.  7750. 


«04  ANIMAL  EXPERIMENTATION 

manner  from  what  I  witnessed  in  the  post'inortem  room. 
Some  time  before  [i.e.,  before  Lister's  discoveries],  when 
reading  a  paper  on  pyemia  [blood  poisoning],  I  had  no 
difficulty  in  collecting  one  hundred  cases  which  had 
occurred  within  a  very  short  time  previously,  when  sud- 
denly this  terrible  malady  disappeared  —  it  was  gone  never 
to  return."  So,  too,  lockjaw  (tetanus),  except  in  accidental 
cuts  that  have  been  neglected  and  have  not  received  proper 
surgical  care,  has  almost  completely  disappeared.  Again, 
at  the  present  day  one  practically  never  sees  erysipelas 
after  hospital  operations;  and  in  order  to  find  illustrations 
of  hospital  gangrene  to  show  to  my  classes  for  the  last 
thirty  years  I  have  had  to  rely  on  pictures  from  the 
"Surgical  History  of  the  Civil  War"  and  other  similar 
sources,  for  I  have  not  seen  a  single  case  in  private  or  hos- 
pital practice  since  I  first  adopted  the  antiseptic  method 
in  1876. 

//.  The  Discovery  and  Development  of  the  Antiseptic  Method  * 

Neither  time  nor  space  will  allow  me  to  describe  the 
many  earlier  steps.  Schwann,  in  1837,  in  studying  putre- 
faction, reached  the  conclusion  that  it  was  not  the  gases 
of  the  air,  especially  the  oxygen,  as  was  then  universally 
believed,  that  caused  putrefaction,  but  organic  particles 
which  floated  in  the  air  and  which  could  be  destroyed  by 
heat.  In  1854  Schroder  and  Dusch  showed  that  putrefac- 
tion did  not  occur  in  organic  fluids  in  flasks  if  the  air  enter- 
ing the  flasks  was  simply  filtered  through  cotton  wool. 
Pasteur,  in  1864,  showed  that  it  was  necessary  neither  to 
heat  the  air  nor  thus  to  filter  it,  for  if  the  air  merely  entered 
through  a  tortuous  tube  in  which  the  dust  could  settle 

1  See  Lord  Lister's  Collected  Papers,  Oxford,  1909  (later  reference  to 
these  Collected  Papers  will  be  indicated  simply  by  "  Lister,  vol.  — , 
p. — "),  the  Lister  number  of  the  Brit.  Med.  Jour.,  December  13,  1902. 
celebrating  the  fiftieth  anniversary  of  his  receiving  his  degree.  Lister's 
"Huxley  Lecture"  in  the  same  journal,  October  6,  1900,  and  Cameron's 
"Lister  and  the  Evolution  of  Wound  Treatment,  etc.,"  Glasgow,  1907. 


AND  MEDICAL  PROGRESS 


205 


before  it  reached  the  fluid  no  change  took  place  in  the 
fluid,  or  if  flasks  containing  a  material  which  would  putrefy 
were  left  open  in  a  place  where  the  air  had  been  undisturbed 
sufficiently  long  to  allow  the  dust  to  settle,  as,  for  example, 
in  a  cellar,  no  decomposition  took  place  and  no  growth 
appeared  in  such  fluids. 

Lister  naturally  was  profoundly  impressed  by  these 
studies  of  Pasteur  and  he  proceeded  to  make  many  experi- 
ments to  confirm  or  disprove  them.  Among  them  I  will 
only  relate  the  following:^  Lister  filled  four  glass  flasks 
one  third  full  of  urine  and 
drew  out  the  neck  of  each 
flask  with  a  spirit  lamp  into 
a  tube  less  than  one  twelfth 
of  an  inch  in  diameter.  Three 
of  these  long  open  tubes  were 
then  bent  at  various  angles 
downward,  while  the  fourth, 
equally  narrow,  was  left  short 
and  vertical.  Each  flask  was 
then  boiled  for  five  minutes, 
after  which  they  were  left 
with  the  ends  of  the  small 
necks    still  open.     Through 

these  open  mouths  the  air,  including  its  oxygen,  would 
pass  out  during  the  heat  of  the  day  and  pass  in  during  the 
colder  night.  The  boiling  was  to  kill  any  organisms  in  the 
liquid  or  on  the  sides  of  the  glass.  The  object  of  the  bend- 
ing of  the  three  necks  downward  was  to  allow  the  air  to 
pass  in  and  out,  but  to  intercept  the  particles  of  dust, 
which,  according  to  the  germ  theory,  caused  putrefaction. 
The  germs,  being  heavier  than  air,  could  not  rise  in  the 
bent  necks  and  reach  the  urine.  The  fourth  neck,  however, 
being  short  and  vertical,  not  only  allowed  the  air  to  pass 
in  and  out,  but  gave  a  very  narrow  but  real  opportunity 
1  Lister,  vol.  ii,  p.  173;  Brit.  Med.  Jour.,  1871,  vol.  ii,  p.  225. 


Flask  with 
the  open  tube 
vertical. 


Flask  with  the 
open  tube  bent 
downwards. 


206  ANIMAL  EXPERIMENTATION 

for  dust  and  germs  to  fall  into  the  liquid.  If  any  of  these 
were  living  organisms,  they  could  produce  putrefaction.  In 
a  short  time  the  vessel  with  the  short  vertical  neck  showed 
growths  of  mold  and  the  hquid  changed  its  color,  showing 
chemical  changes;  but  in  the  three  flasks  with  bent  necks 
the  urine  after  Jour  years  was  entirely  unaltered.  A  year 
after  the  commencement  of  the  experiment  a  little  of  the 
urine  in  one  of  the  flasks  with  a  bent  neck  was  poured  into 
a  wine-glass;  it  had  not  lost  its  original  acidity  and  normal 
odor  and  a  microscope  showed  not  the  minutest  organism. 
In  two  days  it  was  most  offensive,  and  under  the  micro- 
scope already  teemed  with  organisms.  The  three  flasks 
with  bent  necks  were  subjected  to  a  further  severe  and 
rather  amusing  test.  Two  years  after  the  beginning  of  the 
experiment  Lister  had  to  transport  them  from  Glasgow  to 
Edinburgh  on  the  railway  when  he  was  appointed  to  the 
chair  of  surgery  in  Edinburgh.  He  took  charge  of  these 
flasks  himself,  "nursing  them  carefully,"  as  he  says,  "to 
the  amusement  of  my  fellow  travelers."  In  the  drive  from 
the  station  to  his  house  the  violent  rocking  of  the  carriage 
churned  up  the  contents  of  the  flasks  till  the  upper  part 
was  full  of  a  frothy  mixture  of  this  proved  putrescible 
liquid  with  the  atmospheric  gases;  yet  after  two  years  more 
no  decomposition  had  taken  place. 

The  explanation  of  this  convincing  experiment  was 
simply  this :  The  germs  in  the  atmosphere  could  not  rise 
against  gravity  in  any  of  these  tubes  bent  downward  and 
so  could  not  gain  access  to  the  urine.  This  easily  preserved 
a  decomposable  fluid  for  four  years,  although  the  air  passed 
in  and  out  freely  every  day.  But  the  urine  in  the  flask  with 
the  straight  but  very  narrow  neck  in  a  few  days  had  under- 
gone decomposition.  The  only  difference  between  the 
flasks  was  that  the  three  bent  tubes  prevented  the  en- 
trance of  the  germs,  though  not  of  oxygen  or  other 
constituent  of  the  air,  while  the  straight  but  equally  nar- 
row  tube  allowed  the  germs  to  enter  tJirough  in  very 


AND  MEDICAL  PROGRESS  207 

small  quantities,  and  yet  these  few  grew  and  produced 
putrefaction. 

In  order  still  further  to  confirm  this  experiment,  how- 
ever, Lister  tested  these  bent  tubes  by  the  condensed  beam 
of  light  which  Tyndall  had  used  and  found  that  they  were 
optically  empty. ^ 

These  experiments  convinced  him  that  it  was  not  the 
oxygen  or  any  other  gas  in  the  air  that  caused  inflamma- 
tion and  suppuration,  but  that  these  were  caused  by 
minute  organisms  suspended  in  the  air.  In  dressing  a  wound, 
then,  the  problem  was  how  to  exclude  not  the  air  or  its 
oxygen,  which  was  impossible,  but  how  to  exclude  the 
organisms  in  the  air.  This  could  be  done  by  applying  a 
dressing  saturated  with  some  material  capable  of  destroy- 
ing the  life  of  these  germs.  This  was  the  basis  of  the  anti- 
septic method.^  It  must  be  remembered  that  at  that  time 
we  were  wholly  ignorant  of  what  now  everybody  knows, 
that  there  are  hundreds  of  different  kinds  of  germs  or 
bacteria.  Even  the  greatest  scientists  were  then  groping 
in  the  dark  seeking  for  the  light  by  observation  and 
especially  by  experiment. 

About  that  time  Lister  was  much  struck  with  an  account 
of  the  effect  of  mingling  phenol  (carbolic  acid)  with  the 
sewage  of  the  town  of  Carlisle,  England.^  He  proceeded, 
therefore,  to  experiment  with  it  in  compound  fractures. 
I  have  already  stated  how  fatal  a  compound  fracture  was  in 
those  days.  Indeed,  Mr.  Syme,  the  great  Edinburgh 
surgeon,  predecessor  and  father-in-law  of  Lister,  was 
inclined  to  think  that,  on  the  whole,  "it  would  be  better  if 
in  every  case  of  compound  fracture  of  the  leg  amputation 
were  done  without  any  attempt  to  save  the  limb."  The 
marked   success  which    followed  Lister's   dressing  these 

^  See  Tyndall's  charming  lecture  on  "Dust  and  Disease,"  in  Fragments 
of  Science,  1871,  p.  275.  D.  Appleton  &  Co. 

2  Lister,  vol.  ii,  p.  37;  Brit  Med.  Jour.,  1867,  vol.  ii,  p.  246. 

^  Lister,  vol.  ii,  p.  3;  Lancet,  1867,  vol.  i,  pp.  326,  357,  387,  507,  vol.  ii. 
p.  95. 


208  ANIMAL  EXPERIMENTATION 

compound  fractures  ^»  ^  with  carbolic  acid  led  him  then  to 
experiment  with  its  uses  in  abscesses.^' ^'^  This  was  fol- 
lowed again  by  such  remarkable  success  that  he  was  led 
to  try  it  in  accidental  wounds  and  finally  to  intentional 
and  extensive  wounds,  i.e.,  surgical  operations.^ 

Practically  the  progressive  introduction  of  the  antiseptic 
system  from  compound  fractures  up  to  deliberate  surgical 
operations  was  one  vast  experiment  in  the  human  living 
body  —  an  experiment  justified,  as  all  the  world  well 
knows,  by  its  splendid  and  continuing  results.  Yet  when 
in  1880  or  1881  Lister  wished  to  make  additional  experi- 
ments on  animals  to  perfect  his  method  still  further,  so 
stringent  was  the  law  in  England  that  he  was  obliged  to 
go  to  the  Veterinary  School  at  Toulouse,  France.^ 

Like  many  surgeons.  Lister  had  noticed  the  fact  that  a 
needle  or  a  bit  of  glass  would  often  lie  for  an  indefinite 
period  in  the  body  without  producing  inflammation  or 
pus,  but  that  a  bit  of  silk  or  linen  thread  was  sure  to  pro- 
duce pus.  He  believed  the  reason  was  that  the  thread  was 
porous  and  that  its  interstices  contained  these  germs  which 
no  one  had  then  seen  and  identified,  and  that  they  gave 
rise  to  decomposition  and  produced  the  pus.  So,  Lister, 
from  his  previous  experiments  with  phenol  (carbolic  acid) 
believed  that  if  the  thread  with  which  an  artery  was  tied 
were  steeped  in  phenol  and  both  the  ends  of  the  silk  were 
cut  short,  it  might  be  left  in  the  wound  without  producing 
any  inflammation  or  suppuration.  The  wound  could  then 
be  closed  at  once  —  an  immense  gain,  for  it  would  heal  at 
once.    "Before  applying  these  principles  on  the  human 

1  Lister,  vol.  ii,  p.  3;  Lancet,  1867,  vol.  i,  pp.  326,  357,  387,  507;  vol. 
II,  p.  95. 

2  Lister,  vol.  ii,  pp.  3,  32,  37;  Brit.  Med.  Jour.,  1867,  vol.  ii,  p.  246. 

3  Lister,  vol.  ii,  pp.  32,  36,  42;  Brit.  Med.  Jour.,  1867,  vol.  n,  p.  246. 
'*  Lister,  vol.  ii,  pp.  188,  199,  256,  etc.;  Brit.  Med.  Jour.,  1871,  vol.  ii, 

p.  225;  Edinburgh  Med.  Jour.,  1871-72,  vol.  xvii,  p.  144;  iMd.,  1875-76, 
vol.  XXI,  pp.  193,  481. 

^  Lister,  vol.  ii,  p.  281;  Lancet,  1881,  vol.  ii,  pp.  863,  901;  Trans.  Inter- 
nat.  Med.  Cong.,  London,  1881,  vol.  ii,  p.  369. 


AND  MEDICAL  PROGRESS  209 

subject,"  he  says,  "I  thought  it  right  to  test  them  on  one 
of  the  lower  animals."^  Accordingly,  December  12,  1867, 
he  tied  the  great  blood-vessel  in  the  neck  of  a  horse,  having 
steeped  the  silk  for  some  time  in  a  solution  of  phenol. 
Both  ends  were  cut  short,  the  wound  was  entirely  sewed 
up  and  treated  with  phenol  dressings.  Ten  days  after  the 
operation  the  dressings  were  removed,  the  wound  was 
healed,  and  there  was  no  pus!  Thirty-nine  days  after  the 
operation  he  carefully  examined  the  artery  which  he  had 
tied.  The  operation  was  a  complete  success,  the  blood 
current  had  been  entirely  arrested  and  the  thread  had  been 
covered  in  by  dense  fibrous  tissue.  "Thus  encouraged," 
he  says,  "I  felt  justified  in  carrying  a  similar  practice  into 
human  surgery."^  January  29,  1868,^  he  saw  a  woman, 
fifty-one  years  old,  with  an  aneurysm  as  large  as  a  large 
orange  in  the  upper  part  of  the  left  thigh.  (An  aneurysm, 
I  should  explain,  is  a  dilated  portion  of  an  artery,  the  yield- 
ing of  the  wall  being  due  to  disease  of  the  wall  of  the  blood- 
vessel. This  dilatation  continues  to  increase  in  size  till 
finally  the  wall  of  the  artery  is  so  thin  that  it  bursts  and  the 
patient  dies  from  hemorrhage.)  On  the  following  day  he 
tied  the  woman's  artery  with  a  piece  of  silk  which  had 
been  steeped  for  two  hours  in  phenol. 

The  wound  was  treated  like  that  in  the  horse's  neck, 
i.e.,  both  ends  of  the  ligature  were  cut  short,  the  wound 
again  entirely  closed  and  a  phenol  dressing  applied.  The 
patient  was  immediately  relieved  of  the  pain  she  had  pre- 
viously experienced;  she  had  no  fever,  the  pulse  was 
practically  normal  the  entire  time,  and  "her  appetite, 
which  had  been  absent  during  the  four  weeks  of  agony  that 
preceded  the  operation,  returned  two  days  after  it."^  She 
made  a  perfect  recovery.  November  30,  ten  months  after 

*  Lister,  vol.  ii,  p.  64;  Lancet,  1867,  vol.  n,  p.  668. 

2  Lister,  vol.  ii,  p.  65;  Lancet,  1867,  vol.  ii,  p.  668. 

3  Lister,  vol.  ii,  p.  88;  Lancet,  1869,  vol.  i,  p.  451. 

*  Lister,  vol.  ii,  p.  89;  Lancet,  1869,  vol.  i,  p.  451. 


£10 


ANIMAL  EXPERIMENTATION 


the  operation,  she  suddenly  expired.  Fortunately,  Lister 
himself  had  the  opportunity  of  making  the  fost  mortem. 
He  found  that  her  death  was  due  to  the  bursting  of  a 
similar  aneurysm  inside  of  the  chest.  Examining  the  artery 
which  he  had  tied,  he  found  that  the  silk  had  almost  all 
disappeared,  but  that  there  was  a  little  fluid  around  the 
remnant  of  the  ligature,  which  probably  would  have 
developed  into  a  small  abscess  and  might  have  caused  great 
mischief  had  she  lived  longer.  This,  therefore,  suggested 
to  him  the  expediency  of  substituting  for  the  silk  some 
other  substance  which  would  be  more  readily  absorbed.^ 

In  Philadelphia,  years  before,  Dr.  Physick  had  already 
tried  animal  ligatures  made  of  buckskin,  Dorsey  those  of 
kid.  Hartshorn  had  used  parchment,  and  Bellenger  and 
Eve  the  tendon  of  the  deer,  but  for  various  reasons  these 
had  all  been  abandoned.  Lister  determined  to  try  catgut. 
Although  he  had  great  confidence  in  the  use  of  catgut 
steeped  in  a  solution  of  phenol,  yet  he  says^  "in  order  to 
put  the  antiseptic  animal  hgature  to  the  test,  I  made  the 
following  experiment,"  for  only  by  experiment  in  an 
actual  living  body  of  animal  or  man  could  the  question 
whether  it  was  actually  safe  or  not  be  surely  answered. 
December  31,  1868,  he  tied  the  right  carotid  artery  in  the 
neck  of  a  healthy  calf  at  several  places  with  different  kinds 
of  animal  ligature,  including  catgut.  All  were  cut  short 
except  one  end  of  the  catgut,  which  was  purposely  left 
three  quarters  of  an  inch  long  to  determine  what  would 
become  of  this  foreign  material.  The  wound  was  com- 
pletely closed  and  dressed.  After  ten  days  the  dressings 
were  removed  and  the  wound  found  quite  dry.  Thirty 
days  after  the  operation  Lister  says,  on  dissection,  he  was 
struck  with  the  entire  absence  of  any  infection  or  inflam- 
matory thickening  in  the  vicinity  of  the  blood-vessel.  On 
exposing  the  artery  itself  he  was  greatly  disappointed  at 

»  Lister,  vol.  ii,  p.  89;  Lancet,  1869,  vol.  i,  p.  451. 
«  Lister,  vol.  ii,  p.  93;  Lancet,  1869,  vol.  i,  p.  451. 


AND  MEDICAL  PROGRESS  211 

first  to  find  the  ligature  to  all  appearance  still  there  and  as 
large  as  ever.  On  more  careful  examination,  however,  he 
found  that  this  apparent  ligature  was  not  the  catgut  liga- 
ture at  all,  but  that  this  ligature  had  been  transformed  into 
bands  of  living  tissue,  making  the  artery  not  weaker,  as 
silk  often  did,  but  stronger  than  ever  at  the  point  where  it 
was  tied.  The  knots  had  disappeared  and  also  the  three- 
quarters  inch  of  catgut  purposely  left.  Everything  had 
been  absorbed. 

Even  one  not  a  surgeon  can  see  what  an  enormous  differ- 
ence in  rapidity  of  healing  without  inflammation,  pain  or 
other  serious  disturbance  of  the  body  this  use  of  catgut 
with  immediate  total  closure  and  healing  of  the  wound 
provided.  Before  Lister,  the  old  ligatures  hanging  out  in 
bundles  were  always  inviting  infection,  suppuration, 
erysipelas,  lockjaw,  blood  poisoning,  hospital  gangrene 
and  death.  No  patient  was  absolutely  safe  till  the  wound 
was  absolutely  healed  and  this  often  required  weeks  or 
months.  With  the  catgut  ligature,  both  ends  being  cut 
short,  the  wound  closed  at  once,  and,  the  ligature  being 
absorbed,  the  wound  healed  in  less  than  a  week,  not  un- 
commonly in  three  or  four  days,  with  little,  if  any,  immedi- 
ate suffering  and  without  any  ultimate  danger  of  those 
many  serious  complications  above  mentioned.  But  no  one 
not  a  surgeon  can  appreciate  to  the  full  the  meaning  of  these 
brief  words.  While  the  patient  made  a  smooth  and  speedy 
recovery  without  complications,  the  surgeon  slept  the 
uninterrupted  sleep  of  the  just,  secure  against  wearing 
anxiety  on  account  of  sudden  hemorrhage  or  insidious 
infection.  The  heart-breaking  tragedies  which  often  made 
the  surgeon  wish  he  were  a  hod-carrier  or  even  in  his  grave 
are  now  but  specters  of  a  horrid  past. 

As  I  have  said,  we  had  no  idea  at  first  of  the  enormous 
variety  and  different  characters  of  the  germs.  In  his  early 
studies  on  putrefaction,  Lister  spoke  of  them  in  a  general 
way  as  "germs,"  because  the  various  species  of  plants  (for 


212  ANIMAL  EXPERIMENTATION 

they  are  plants  and  not  animalculse)  had  not  been  dis- 
tinguished. Now  there  are  scores  and  even  hundreds  of 
known  varieties.  Many  of  these  simply  cause  putrefaction 
or  decomposition  and  are  not  in  themselves  capable  of 
giving  origin  to  any  particular  disease.  Other  varieties, 
each  one  of  which  causes  a  special  disease  and  can  cause  no 
other  disease,  have  been  isolated  and  identified.  Some  of 
these  germs  cause  medical  diseases,  with  which  I  have 
nothing  to  do  here.  The  germs  of  lockjaw,  tuberculosis, 
anthrax  (wool  sorters'  disease),  erysipelas,  glanders,  etc., 
are  among  the  most  virulent  foes  with  which  the  surgeon 
has  to  contend. 

How  have  these  been  identified  and  how  do  we  prevent 
their  entrance  into  the  system  of  the  patient?  The  process 
is  very  simple  to  describe,  but  very  compHcated  and  diffi- 
cult practically .  Let  us  take  the  case  of  lock  j  aw  for  instance. 
A  pecuhar  kind  of  germ,  looking  a  good  deal  like  a  tack 
with  a  straight  body  and  a  large  head  at  one  end,  was  dis- 
covered by  animal  experiments  by  Nicolaier  in  earth  and 
dust  in  1884.1  j^  1889  Kitasato,  the  Japanese  bacteriolo- 
gist,2  first  obtained  it  in  pure  culture  (i.e.,  free  from  all 
other  germs),  former  experimenters  having  failed  because 
they  did  not  know  that  it  only  grows  well  when  oxygen 
is  excluded. 

Eut  how  do  we  know  that  this  tack-like  germ  and  it  alone 
is  the  cause  of  lockjaw? 

First,  in  a  patient  ill  with  lockjaw,  this  particular 
bacillus  or  germ  must  be  discovered. 

Second,  a  pure  culture  of  it  must  be  produced;  that  is 
to  say,  the  tetanus  bacillus  must  be  separated  from  all 
other  germs  and  cultivated  by  itself. 

Third,  some  of  this  pure  culture  of  tetanus  unmixed 
with  any  other  germs  whatever  must  be  injected  into  an 
animal  to  see  point-blank  whether  this  particular  bacillus 
will  produce  lockjaw. 
•    »  Deutsch.  med.  WocK  1884,  no.  52,  p.  842.      2  /j^-j.,  iggg,  no.  31. 


AND  MEDICAL  PROGRESS  213 

Fourth,  from  the  body  of  this  animal  the  same  germ 
that  was  injected  must  be  recovered. 

Fifth,  with  a  pure  culture  of  this  recovered  bacillus  the 
cycle  must  be  begun  over  again  and  completed  sufficiently 
frequently  to  assure  the  experimenter  that  the  connection 
between  the  disease  and  the  germ  is  not  accidental,  but 
essential  and  invariable. 

Sixth,  no  other  germ  used  in  the  same  way  must  pro- 
duce lockjaw. 

In  this  same  manner  the  germs  that  produce  inflamma- 
tion and  suppuration,  which  are  the  ever-present  danger  to 
the  surgeon,  have  been  identified,  and  also,  what  is  equally 
important,  the  places  where  they  and  many  others  exist. 
In  this  way  we  have  determined  the  fact  that,  while  there 
are  some  in  the  air,  they  are  few  in  number  and  so  constitute 
a  small  though  a  real  danger.  But  the  places  where  they 
are  found  and  are  most  dangerous  are  on  the  skin  and 
clothing  of  the  patient,  the  hands  of  the  surgeon  and 
especially  under  his  finger  nails  and  at  the  roots  of  his 
finger  nails,  on  instruments,  dressings,  silk,  catgut,  and 
other  things  used  for  ligatures;  in  fact,  practically  every 
material  that  one  can  think  of.  We  know  now  how  all- 
pervading  they  are.  We  know,  too,  that  phenol  (carbolic 
acid),  corrosive  sublimate  and  other  chemicals,  or  that 
boiling  for  a  certain  time,  or  heating  to  a  certain  degree 
and  for  a  certain  time,  will  kill  these  germs.  Thousands  of 
such  painstaking  researches  in  test-tubes  and  by  many 
other  bacteriologic  methods  have  been  carried  out  all  over 
the  world  by  men  either  wholly  unpaid,  working  for  the 
love  of  truth  and  love  of  their  fellow  creatures,  or  paid  but 
meager  pittances.  Then  when  a  discovery  seems  to  have 
been  made  comes  the  needful,  the  finally  convincing,  the 
unavoidable  experiment — in  a  living  body  itself.  The  only 
question  is  should  Lister  have  made  this  final  test  first  on  a 
horse  and  a  calf,  or  on  two  human  beings?  Can  any  one 
with  a  sane,  well-balanced  mind  hesitate  as  to  the  answer? 


214  ANIMAL  EXPERIMENTATION 

III.  The  Results 

The  results  of  the  establishment  of  the  antiseptic  method 
have  been  so  extraordinary  as  to  be  incredible  were  it  not 
for  ample  testimony  the  world  over.  They  have  been 
already  stated  in  part,  but  a  few  words  more  must  be 
added. 

At  present  before  an  operation  is  begun  the  patient's 
skin,  the  surgeons'  and  the  nurses'  hands  are  scrupulously 
disinfected,  sterile  gloves  are  usually  worn  and  every  person 
is  clothed  in  a  disinfected  gown.  The  instruments,  dress- 
ings, Ugatures,  everything  that  is  to  come  in  contact  with 
the  wound,  is  carefully  disinfected.  Disinfected  gauge 
"sponges"  are  used  once  and  then  discarded. 

It  is  almost  impossible  for  any  one  not  a  surgeon  to 
understand  how  different  are  the  results  from  this  radical 
change  of  methods.  No  change  of  climate  from  fierce  mid- 
winter storms  to  lovely  summer  breezes  or  autumn  golden 
harvest  could  be  greater.  Most  wounds  now  heal  within  a 
few  days,  often  one  might  almost  say  without  the  patient's 
being  sick.  Compound  fractures  and  opened  joints  heal  as  if 
there  had  been  no  break  in  the  skin.  Arteries  can  be  tied 
anywhere  without  fear  of  secondary  hemorrhage.  The  ab- 
domen is  now  fearlessly  opened. 

A  woman  with  an  ovarian  tumor  no  longer  has  an  opera- 
tion postponed  until  it  is  very  dangerous  but  inevitable, 
but  by  early  operation  is  relieved  almost  without  danger, 
even  from  tumors  so  large  as  to  weigh  twice  as  much  as  the 
patient  herself.  When  I  was  assistant  to  Dr.  Washington 
Atlee  in  the  late  sixties,  before  the  antiseptic  period,  two 
out  of  three  of  his  ovariotomy  patients  died,  yet  he  was  the 
then  most  famous  operator  in  America.  Now  any  surgeon 
who  loses  more  than  five  out  of  one  hundred  is  looked  at 
askance  by  his  colleagues,  and  many,  many  hundreds  of 
cases  have  been  operated  on  with  a  mortality  falling  even 
below  one  per  cent.  There  is  not  an  organ  in  the  abdomen 


AND  MEDICAL  PROGRESS  215 

that  has  not  been  attacked;  organs  which  formerly  when 
diseased  could  not  be  touched  because  death  was  almost 
sure  to  follow  are  now  operated  on  every  day.  In  fact  as  I 
once  described  it,  the  abdominal  cavity  is  almost  the  sur- 
geon's playground!  The  stomach,  the  intestines,  the  liver, 
the  gall  bladder,  the  pancreas,  the  spleen,  the  kidney,  every 
organ  is  operated  on,  and  with  extraordinary  success.  Did 
space  permit,  a  more  detailed  statement  could  be  given, 
but  it  could  scarcely  be  more  convincing. 

In  obstetrics  the  same  happy  results  have  followed  the 
introduction  of  the  antiseptic  method.  Puerperal  or 
"childbed*'  fever,  which  not  uncommonly  used  to  kill  one 
half  or  two  thirds  or  even  three  fourths  of  the  women  in 
the  maternity  wards  of  a  hospital,  now  is  practically  un- 
known except  in  the  neglected  cases  brought  into  the  hos- 
pital at  a  late  date,  and  the  pre-antiseptic  general  mortality 
in  maternity  cases  has  been  reduced  from  ten  per  cent  or 
more  to  one  per  cent  and  less.  Brain  tumors,  abscesses 
and  other  diseases  of  the  brain  formerly  inevitably  caused 
death,  for  we  never  dared  to  touch  them.  Now  the  number 
of  recoveries  is  very  large.  Compound  fractures  now  have 
a  mortality  of  two  or  one  per  cent  or  less,  instead  of  over 
sixty  per  cent,  and  now  very  rarely  require  amputation; 
and  amputations  formerly  followed  by  death  in  one  half 
the  cases  have  a  mortality  of  ten  per  cent  or  less.  In 
general,  both  the  soldier  and  the  sailor  are  provided  with 
the  first-aid  packet,  which  contains  an  antiseptic  dressing. 
This  has  enormously  diminished  the  mortality  of  wounds 
received  in  battle. 

Perhaps  no  better  evidence  of  the  value  of  the  anti- 
septic method  in  civil  life  can  be  adduced  than  the  results 
in  three  hospitals.  In  Munich*  the  General  Hospital  was 
excessively  unhealthy.  Blood  poisoning  was  very  frequent 
and  hospital  gangrene,  which  had  appeared  in  1872,  had 
become  annually  a  more  and  more  frightful  scourge  until 
1  Lister,  vol.  ii,  p.  248;  Brit.  Med.  Jour.,  1875,  vol.  ii,  p.  769. 


216  ANIMAL  EXPERIMENTATION 

1874,  when  eighty  per  cent  of  all  wounds  that  occurred  in 
the  hospital,  whether  accidental  or  inflicted  by  the  surgeon, 
were  attacked  by  it !  At  the  beginning  of  1875  Nussbaum 
introduced  the  antiseptic  treatment.  From  then  on  till 
Lister's  visit,  presumably  in  the  summer  of  1875,  not  one 
single  case  of  hospital  gangrene  had  occurred  and  only  one 
case  of  blood  poisoning,  and  that  a  doubtful  one.  Erysipe- 
las was  rare  and  mild  instead  of  being  very  prevalent  and 
severe,  and  the  convalescent  wards,  which  formerly  had 
been  filled  to  overflowing,  stood  practically  empty.  In 
Halle,  ^  Volkmann  was  operating  in  an  extremely  unhealthy 
hospital  in  small,  overcrowded  wards,  with  the  toilet  rooms 
opening  directly  into  them  and  a  large  drain  running 
directly  underneath.  It  was  so  bad  that  it  had  been  con- 
demned to  demolition.  After  his  introduction  of  the  anti- 
septic method  in  1872,  no  single  patient  suffering  from  com- 
pound fracture  in  which  conservative  treatment  was 
attained  had  died  either  from  the  fracture  or  from  a  neces- 
sary amputation,  nor  was  there  a  single  death  from  second- 
ary hemorrhage  or  gangrene.  No  case  of  blood  poisoning 
had  occurred  for  a  year  and  a  half,  though  sixty  amputa- 
tions had  been  done.  Hospital  gangrene  had  entirely  dis- 
appeared and  erysipelas  was  extremely  rare  and  mild. 

Perhaps,  however,  the  most  extraordinary  success  was 
obtained  by  Lister  ^  in  his  own  wards  in  Glasgow.  Lister 
was  professor  of  surgery  in  Glasgow  from  March,  1865, 
till  the  autumn  of  1869,  but  in  that  brief  period  he  intro- 
duced measures  that  were  absolutely  revolutionary.  The 
Royal  Hospital  in  Glasgow  was  overcrowded,  and  in  some 
parts  of  the  building  the  conditions  were  so  frightful  that 
the  wards  had  to  be  entirely  shut  up  for  a  time.  Lister's 
own  account  of  this  is  interesting.  He  says :  — 

A  crisis  of  this  kind  occurred  rather  more  than  two  years  ago 
in  the  other  male  accident  ward  on  the  ground  floor,  separated 

1  Lister,  vol.  ii,  p.  250;  Brit  Med.  Jour.,  1875,  vol.  ii,  p.  769. 
'  Lister,  vol.  ii,  p.  124;  Lancet,  1870,  vol.  i,  pp.  4,  40. 


AND  MEDICAL  PROGRESS  217 

from  mine  merely  by  a  passage  twelve  feet  broad,  where  the  mor- 
tality became  so  excessive  as  to  lead,  not  only  to  closing  the  ward, 
but  to  an  investigation  into  the  cause  of  the  evil,  which  was  pre- 
sumed to  be  some  foul  drain.  An  excavation  made  with  this  view 
disclosed  a  state  of  things  which  seemed  to  explain  sufficiently 
the  unhealthiness  that  had  so  long  remained  a  mystery.  A  few 
inches  below  the  surface  of  the  ground,  on  a  level  with  the  floors 
of  the  two  lowest  male  accident  wards,  with  only  the  basement 
area,  four  feet  wide,  intervening,  was  found  the  uppermost  tier 
of  a  multitude  of  coffins,  which  had  been  placed  there  at  the  time 
of  the  cholera  epidemic  of  1849,  the  corpses  having  undergone  so 
little  change  in  the  interval  that  the  clothes  they  had  on  at  the 
time  of  their  hurried  burial  were  plainly  distinguishable.  The 
wonder  now  was,  not  that  these  wards  on  the  ground  floor  had 
been  unhealthy,  but  that  they  had  not  been  absolutely  pestilen- 
tial. Yet  at  the  very  time  when  this  shocking  disclosure  was 
being  made,  I  was  able  to  state,  in  an  address  which  I  delivered  to 
the  meeting  of  the  British  Medical  Association  in  DubHn,^  that 
during  the  previous  nine  months,  in  which  the  antiseptic  system 
had  been  fairly  in  operation  in  my  wards,  not  a  single  case  of 
pyemia  [blood  poisoning],  erysipelas,  or  hospital  gangrene  had 
occurred  in  them;  and  this,  be  it  remembered,  not  only  in  the 
presence  of  conditions  likely  to  be  pernicious,  but  at  a  time  when 
the  unhealthiness  of  other  parts  of  the  same  building  was  attract- 
ing the  serious  and  anxious  attention  of  the  managers.  Supposing 
it  justifiable  to  institute  an  experiment  on  such  a  subject,  it 
would  be  hardly  possible  to  devise  one  more  conclusive. 

Having  discovered  this  monstrous  evil,  the  managers  at  once 
did  all  in  their  power  to  correct  it.  .  .  .  But  besides  having  along 
one  of  its  sides  the  place  of  sepulture  above  alluded  to,  one  end  of 
the  building  is  coterminous  with  the  old  cathedral  churchyard, 
...  in  which  the  system  of  "pit  burial"  of  paupers  has  hitherto 
prevailed.  I  saw  one  of  the  pits  some  time  since.  .  .  .  The  pit, 
which  was  standing  open  for  the  reception  of  the  next  corpse, 
emitted  a  horrid  stench  on  the  removal  of  some  loose  boards  from 
its  mouth.  Its  walls  were  formed  on  three  sides  of  coffins  piled  one 
upon  another  in  four  tiers,  with  the  lateral  interstices  between 
them  filled  with  human  bones,  the  coffins  reaching  up  to  within  a 
few  inches  of  the  surface  of  the  ground.  This  was  in  a  place  imme- 
diately adjoining  the  patients'  airing  ground,  and  a  few  yards 
only  from  the  windows  of  the  surgical  wards!  And  the  pit  which 
I  inspected  seems  to  have  been  only  one  of  many  similar  recep- 

1  Lister,  vol.  ii,  p.  45. 


218  ANIMAL  EXPERIMENTATION 

tacles,  for  the  "Lancet"  of  September  25  contains  a  statement, 
copied  from  one  of  the  Glasgow  newspapers,  that  "the  Dean  of 
Guild  is  said  to  have  computed  that  five  thousand  bodies  were 
lying  in  pits,  holding  eighty  each,  in  a  state  of  decomposition, 
around  the  infirmary." 

When  to  all  this  is  added  the  fact  that  the  large  fever 
hospital  was  separated  from  the  surgical  hospital  by  only 
eight  feet,  tliat  Lister's  hospital  of  nearly  six  hundred  beds 
was  cramped  in  area  and  almost  always  full  to  overflow- 
ing, and  that  he  was  operating,  it  might  almost  be  said, 
in  a  charnal  house,  yet  that  those  wards  were  continuously 
and  conspicuously  healthy  and  enjoyed  for  "three  years 
immunity  from  the  ordinary  evils  of  surgical  hospitals 
under  circumstances  which  but  for  the  antiseptic  system 
were  specially  calculated  to  produce  them,"  ^  we  stand 
convinced  by  such  a  huge  unintentional  experiment  on 
man  himself. 

Were  not  results  such  as  these  sufficient  to  justify  the 
experiments  on  animals  as  related  by  Lister  himself  and 
here  quoted,  by  which  such  blessed  relief  has  been  brought 
to  mankind? 

What  was  seen  in  Glasgow  has  occurred  all  over  the 
worid.  The  surgical  revolution  of  the  last  thirty  years 
is  the  most  momentous  in  the  entire  history  of  surgery. 
In  every  science  —  chemistry,  engineering,  botany,  phys- 
ics, electricity  —  the  era  of  precise  experiments  has  been 
the  era  when  enormous  and  constant  progress  has  been 
made.  Medicine  is  no  exception.  We  have  closely  studied 
disease  by  various  observational  methods,  and  clinical 
obsersration  for  two  thousand  years  had  slowly  advanced 
our  knowledge  up  to  a  certain  point.  Then  experimental 
research,  which  employed  methods  of  precision,  varying 
conditions  at  will,  noting  the  different  results,  and  multi- 
plying the  experiments  at  will  instead  of  waiting,  it  might 
even  be  years,  until  Nature's  second  experiment  occurred, 
'  Lister,  vol.  ii,  p.  126;  Lancet,  1870,  vol.  i,  pp.  4,  40. 


AND  MEDICAL  PROGRESS  219 

began  Its  work;  and  in  the  past  thirty  years  experimental 
research  has  produced  a  more  fruitful  harvest  of  good  to 
animals  and  to  mankind  than  the  clinical  observation 
during  thirty  preceding  centuries. 

But  we  are  far  from  having  attained  perfection.  In 
medicine  and  in  surgery  many  problems  of  disease  and 
death  are  still  awaiting  solution  and  can  only  be  solved 
by  the  experimental  method.  A  number  of  organs  in  the 
body  are  as  yet  inaccessible  and  others  have  functions  of 
which  we  know  little  or  nothing.  Many  operations  ought 
to  be  bettered  in  method  and  in  results.  The  cause  of 
many  diseases,  such  as  cancer,  scarlet  fever,  measles, 
whooping-cough,  etc.,  are  as  yet  unknown.  To  dispel  all 
this  ignorance  and  discover  a  cure  for  all  these  and  other 
diseases  is  the  earnest  wish  of  wise  and  humane  experi- 
menters the  world  over.  Shall  the  community  aid  these 
humane  life-saving  efforts,  or  shall  they  by  restrictive 
legislation  call  a  halt  and  let  death  slay  our  fellow  creatures 
and  especially  our  dear  children?  The  answer  is  clear.  It 
will  never  be  other  than  an  emphatic  no  to  the  latter  cruel 
course. 


WHAT  VIVISECTION  HAS   DONE  FOR 
HUMANITY! 

In  1905  I  had  made  all  my  arrangements  to  do  an 
operation  on  a  Thursday  morning.  Among  my  assistants 
was  Dr.  C.  On  Wednesday  morning  he  telephoned  and 
said  he  was  not  feeling  very  well  and  that  I  had  better 
engage  some  one  to  take  his  place.  This  I  did,  giving  no 
special  thought  to  the  matter,  supposing  it  was  an  unim- 
portant passing  illness.  At  ten  o'clock  that  same  night  I 
was  startled  by  a  telephone  message  that  if  I  wished  to 
see  Dr.  C.  alive  I  must  come  at  once!  In  a  few  minutes  I 
was  there,  but  he  was  already  unconscious.  As  I  sat  beside 
him  and  his  weeping  young  wife,  who  soon  expected  to 
become  a  mother,  how  I  longed  for  some  means  by  which 
the  hand  of  death  coxild  be  stayed;  but  he  died  in  less  than 
thirty-six  hours  from  the  time  that  he  was  seized  with 
epidemic  cerebro-spinal  meningitis. 

On  June  16,  1909,  Charles  E.  Hughes,  Jr.,  son  of  the 
Governor  of  New  York  State,  and  president  of  his  class, 
was  graduated  at  Brown  University.  A  few  weeks  earlier 
he  had  been  suddenly  seized  with  a  violent  attack  of  the 
same  disease  —  epidemic  cerebro-spinal  meningitis.  When 
some  of  the  fluid  aroxmd  his  spinal  cord  was  removed  by 
"lumbar  puncture"  —  that  is,  pimcture  of  the  spinal 
canal  in  the  small  of  the  back  by  a  hypodermic  needle  — 
there  settled  to  the  bottom  of  the  test-tube  a  half  inch 
of  pure  pus  ("matter").  No  medical  man  famihar  with 
this  terrible  disease  would  have  thought  it  possible  that  he 
could  recover  when  such  a  condition  existed.    But  in  1907, 

^  Reprinted,  by  permission  from  the  Ladies'  Home  Journal,  April,  1910, 
and  of  the  Council  on  Defense  of  Medical  Research  of  the  American 
Medical  Association.  It  is  Pamphlet  no.  xiv  in  their  series.    (See  p.  xix.) 


MEDICAL  PROGRESS  «21 

midway  between  the  death  of  Dr.  C.  and  the  case  of  young 
Hughes,  Drs.  Flexner  and  Jobling,  of  the  Rockefeller  In- 
stitute, had  discovered  by  researches  on  animals  alone  a 
serum  against  this  disease.  Three  doses  of  this  serum 
were  administered  also  by  "lumbar  puncture"  to  young 
Hughes.  Within  twenty-four  hours  after  the  first  dose  his 
temperature  fell  to  normal.  The  pus  disappeared  after  the 
second  dose  and  he  soon  recovered  and  was  able  to  take 
his  degree  in  the  presence  of  his  proud  father.  The  trag- 
edy in  the  case  of  Dr.  C.  was  averted,  a  useful  life  was 
spared,  and  a  family  made  happy. 

In  discovering  this  serum  Dr.  Flexner  experimented 
on  twenty-five  monkeys  and  one  hundred  guinea-pigs. 
Many  of  these  animals  themselves  had  been  cured  by  the 
use  of  the  serum.  Having,  therefore,  found  it  effective  in 
animals  he  proceeded  to  test  it  on  human  beings.  Before 
the  introduction  of  the  serum,  medicine  was  almost  help- 
less. Whatever  treatment  was  adopted  seventy-five  to 
ninety  patients  out  of  one  hundred  were  sure  to  die.  In 
two  years  this  serum  has  been  used  in  this  coimtry  and  in 
Europe  in  about  one  thousand  cases.  In  these  one  thousand 
cases  the  mortality  has  dropped,  in  different  series  each 
under  the  care  of  the  reporter,  to  thirty,  twenty,  ten,  and 
even  to  seven  in  a  hundred.  If  we  take  the  mortality  of 
the  days  before  the  serum  treatment  was  used  at  seventy- 
five  per  cent,  and  the  mortality  since  it  was  discovered,  say, 
at  twenty-five  per  cent,  there  is  a  clear  saving  of  five  hun- 
dred human  lives!  Not  only  have  five  hundred  human 
lives  been  saved  in  these  first  one  thousand  cases,  but  for 
all  time  to  come  in  every  thousand  five  hundred  more 
human  lives  will  be  saved. 

Moreover,  we  must  not  forget  that  these  thousands 
who  would  die  were  it  not  for  Dr.  Flexner's  serum  had 
families  and  friends  who  would  have  been  filled  with 
sorrow,  and,  in  case  it  was  the  bread-winner  of  the  family 
whose  life  was  lost,  would  have  had  to  suffer  the  depriva- 


«22  ANIMAL  EXPERIMENTATION 

tions  and  pangs  of  poverty  and  the  community  have  had 
to  assume  their  support. 

Let  me  now  put  a  plain,  straightforward,  common-sense 
question.  Which  was  the  more  cruel:  Doctor  Flexner  and 
his  assistants  who  operated  on  twenty-five  monkeys  and 
one  hundred  guinea-pigs  with  the  pure  and  holy  purpose 
of  finding  an  antidote  to  a  deadly  disease  and  with  the 
result  of  saving  hundreds,  and,  in  the  future,  of  thousands 
on  thousands  of  human  fives;  or  the  women  who  were 
"fanned  into  fury"  in  their  opposition  to  all  experiments 
on  fiving  animals  at  the  Rockefeller  Institute,  "no  matter 
how  great  the  anticipated  benefit"? 

If  these  misguided  women  had  had  their  way,  they 
would  have  nailed  up  the  doors  of  the  Rockefeller  Institute, 
would  have  prevented  these  experiments  on  one  hundred 
and  twenty-five  animals,  and  by  doing  so  would  have 
ruthlessly  condemned  to  death  for  all  future  time  five 
hundred  human  beings  in  every  one  thousand  attacked  by 
cerebro-spinal  meningitis! 

If  your  son  or  daughter  falls  ill  with  this  disease,  to 
whom  will  you  turn  for  help  —  to  Flexner  or  to  the  anti- 
vivisectionists? 

Of  these  one  hundred  and  twenty-five  animals,  as  a  rule 
those  which  died  became  unconscious  in  the  course  of  a 
few  hours  and  remained  so  for  a  few  hours  more  till  they 
died.  They  suffered  but  little.  When  they  died  they  left  no 
mourning  families  and  friends.  They  left  undone  no  deeds 
of  service  or  of  heroism  to  either  their  fellows  or  to  the 
human  race,  as  the  human  beings  whose  lives  were  rescued 
by  their  death  may  do.  But  these  deluded  women  had  their 
minds  so  centered  on  the  sufferings  of  these  one  hundred 
and  twenty-five  animals  that  their  ears  were  deaf  and  their 
hearts  steeled  against  the  woes  and  the  sufferings  of  thou- 
sands of  human  beings,  their  families,  and  their  friends.  Is 
this  common  sense?  Are  not  human  beings  "of  more  value 
than  many  sparrows"? 


AND  MEDICAL  PROGRESS  223 

Less  than  two  years  ago  their  first  baby  was  born  to 
a  young  doctor  and  his  wife  in  New  York  City.  Scarcely 
was  the  child  born  before  it  began  to  bleed  from  the  nose, 
the  mouth,  the  gums,  the  stomach,  and  the  bowels.  It  was 
a  case  which  we  know  as  "hemorrhage  of  the  newborn," 
which  attacks  about  one  baby  in  every  thousand.  It  is 
very  frequently  fatal,  and  in  treating  it  up  to  that  time 
physicians  practically  groped  in  the  dark,  trying  one  rem- 
edy after  another,  but,  alas,  too  often  in  vain! 

The  bleeding  continued.  This  poor  little  baby  soon 
showed  the  pallor  which  accompanies  severe  loss  of  blood. 
It  lost  all  appetite,  was  suffering  from  high  fever,  and, 
finally,  by  the  fourth  day  the  physician  in  attendance  told 
the  parents  frankly  that  the  child  could  live  only  a  few 
hours.  Then,  in  the  dead  of  the  night,  the  father  wakened 
Dr.  Carrel,  one  of  the  assistants  in  the  Rockefeller  Insti- 
tute. The  father  lay  down  alongside  of  his  firstborn.  The 
artery  of  the  pulse  in  the  father's  arm  was  laid  bare  and 
sewed  end-to-end  to  a  vein  in  his  baby's  leg,  and  the  blood 
was  allowed  to  flow  from  father  to  child.  The  result  was 
most  dramatic.  A  few  minutes  after  the  blood  began  to 
flow  into  the  baby's  veins,  its  white,  transparent  skin 
assumed  the  ruddy  glow  of  health,  the  hemorrhage  from 
every  part  of  the  body  ceased  instantly  and  never  returned, 
and,  as  Dr.  Samuel  Lambert,  who  reports  the  case,  puts  it, 
there  was  no  period  of  convalescence;  immediately  before 
the  operation  the  baby  was  dying;  immediately  after  the 
operation  it  was  well  and  strong  and  feeding  with  avidity. 
That  baby  to-day,  after  two  years,  as  I  know  personally, 
is  a  splendid  specimen  of  a  healthy  child. 

Perhaps  my  readers  may  see  nothing  very  wonderful 
in  this,  but  we  surgeons  know  that  it  is  one  of  the  most 
remarkable  recent  achievements  in  surgery.  For  many 
years  we  have  been  trying  to  devise  a  method  by  which 
we  could  sew  severed  blood-vessels  end-to-end  without 
danger  to  the  patient.    The  difficulty  has  always  been 


224  ANIMAL  EXPERIMENTATION 

that,  no  matter  what  were  the  methods  employed,  the 
blood  nearly  always  formed  clots  at  the  roughened  ring 
where  the  two  ends  of  the  divided  blood-vessels  were  sewed 
together.  These  clots  passed  up  to  the  heart  and  into  the 
lungs  of  the  patient  and  produced  pneumonia,  so  that  the 
old  method  of  transfusion  of  blood  has  been  practically 
abandoned  for  years.  Dr.  Carrel  worked  out  his  new 
method  on  the  blood-vessels  of  dead  human  beings,  and, 
when  it  seemed  to  him  to  be  satisfactory,  put  it  to  the  proof 
on  two  Hving  dogs,  and  then  used  it  in  living  human  beings. 
It  is  now  in  use  everywhere. 

Moreover,  Dr.  Crile,  of  Cleveland,  who  has  so  splen- 
didly enlarged  our  means  of  coping  with  disease,  has  used 
the  same  method  in  another  way.  When  patients  come 
to  him  too  weak  to  be  operated  on  and  ordinary  tonics  and 
food  do  not  strengthen  them,  he  has  transfused  the  blood 
from  husband,  father  or  son,  and  thus  given  the  patient 
suflScient  strength  to  bear  the  operation.  He  has  used  even 
a  more  striking  method.  For  example  when  a  woman  has 
to  be  operated  on  —  say  for  cancer  of  the  breast  —  and 
is  so  weak  that  the  shock,  the  anesthetic  and  the  loss  of 
blood  would  probably  turn  the  scale  against  her,  he  has 
had  the  husband  he  down  alongside  of  her,  has  sewed  the 
artery  of  the  pulse  of  the  husband  to  a  vein  in  his  wife's 
leg  and  allowed  the  blood  to  flow.  In  a  few  minutes,  when 
she  has  become  strong  enough,  he  has  etherized  her  and 
proceeded  with  the  operation,  starting  or  stopping  the 
flow  of  blood  according  to  the  varying  needs  of  the  patient. 
At  the  end  of  the  operation,  through  the  new  life-blood 
that  has  been  given  her,  the  patient  has  been  in  better 
condition  than  when  the  operation  began.  These  methods, 
too,  are  now  in  successful  use  by  other  surgeons. 

Let  me  again  put  the  plain,  straightforward,  common- 
sense  question:  Who  is  the  more  cruel:  Dr.  Carrel,  in 
devising  this  life-saving  method  of  transfusion  of  blood 
by  experimenting  on  two  living  dogs,  and  saving  through 


AND  MEDICAL  PROGRESS  225 

himself  and  other  surgeons  scores  of  Uves  already,  and  even 
thousands  in  the  future;  or  the  women  who  would  shackle 
him,  shut  up  the  Rockefeller  Institute  and  thrust  these 
poor  patients  into  their  graves?  Does  not  the  work  of 
Drs.  Flexner,  Jobling  and  Carrel  and  their  assistants  not 
only  justify  the  existence  of  the  Rockefeller  Institute,  but 
also  bid  us  tell  them  Godspeed  in  their  mission  of  mercy, 
and  give  them  and  those  engaged  in  similar  blessed  work 
all  over  the  world  our  confidence,  encouragement  and  aid? 
Is  it  just,  is  it  fair,  is  it  Christian  to  call  such  an  institution 
a  "hell  at  close  range,"  as  the  Rockefeller  Institute  is  called 
in  a  pamphlet  written  by  a  woman  and  distributed  by  anti- 
vivisectionists  ? 

I  suppose  that  in  this  day  of  general  intelligence  scarcely 
any  person,  obUged  to  submit  to  an  operation,  would 
be  willing  to  have  it  done  by  a  surgeon  who  did  not 
use  antiseptic  methods.  These  methods  we  owe  to  Lord 
Lister,  of  London,  still  living  in  his  eighty-third  year.  Few 
of  my  readers,  however,  know  how  enormous  the  contrast 
is  between  the  days  before  Lister's  discoveries  and  the 
present.  I  was  graduated  in  medicine  in  186£.  The  anti- 
septic method  was  adopted  by  various  surgeons,  we  may 
say  roughly,  between  the  years  1875  and  1880.  Prior  to 
1876  I  practiced  the  old  surgery,  but  ever  since  then  the 
new  antiseptic  method.  I  passed  through  the  horrible 
surgery  of  the  Civil  War,  when  blood  poisoning,  erysipelas, 
lockjaw,  hospital  gangrene,  and  all  the  other  fearful  septic 
conditions  were  everyday  affairs.  In  five  hundred  and 
five  cases  of  lackjaw  during  the  Civil  War  four  hundred 
and  fifty-one  patients  died.  In  wounds  of  the  intestines 
the  mortality  was  ninety-nine  out  of  a  hundi^ed.  In  sixty- 
six  cases  of  amputation  at  the  hip-joint,  fifty-five  patients 
died.  In  one  hundred  and  fifty-five  cases  of  trephining, 
ninety-five  patients  died.  After  the  war  for  some  years  I 
was  an  assistant  of  Dr.  Washington  L.  Atlee.  A  more 
careful  surgeon  I  never  saw,  but  two  out  of  every  three  of 


226  ANIMAL  EXPERIMENTATION 

his  patients  died.  There  are  now  many  surgeons  who  can 
show  series  of  hundreds  and  even  thousands  of  cases  of 
ovariotomy  and  other  abdominal  operations  with  a  mor- 
taUty  of  only  five  in  a  hundred,  and  some  of  only  one  in  a 
hundred.  After  "clean"  operations  —  that  is,  with  no 
"matter"  present  —  blood  poisoning,  lockjaw,  and  erysip- 
elas are  well-nigh  unknown,  and  I  have  not  seen  a  single 
case  of  hospital  gangrene  in  the  thirty-five  years  since  I 
adopted  the  antiseptic  method. 

One  of  the  most  common  operations  is  amputation  of 
the  breast  for  cancer,  in  which  now  we  do  far  more  exten- 
sive operations  than  formerly.  These  operations  are  fol- 
lowed by  permanent  cure  in  more  than  one  half  of  the 
patients  operated  on  early,  and  rarely  more  than  one  or 
two  women  in  every  hundred  die.  Recovery  also  follows 
in  a  few  days  and  not  seldom  with  but  Httle  pain,  instead 
of  several  weeks  or  even  months  of  great  suffering  as 
before  the  days  of  antisepsis. 

All  of  this  wonderful  improvement  we  owe  to  Lord 
Lister  and  the  new  science  of  bacteriology  which  treats 
of  "bacteria"  or  "germs."  Both  Lister's  work  and  that 
of  the  bacteriologist  are  and  must  be  absolutely  founded 
finally  on  experiments  on  animals.  The  laboratory  was 
of  use,  but,  in  order  to  be  absolutely  certain  that  he  was 
right  he  had  to  experiment  on  a  few  animals  —  the  only 
possible  way  of  achieving  positive  knowledge. ^ 

Who,  I  ask,  are  the  more  humane:  Lord  Lister  and 
other  surgeons  who  have  made  these  life-giving,  pain- 
saving  experiments  on  animals,  or  those  who  —  if  they 
had  succeeded  in  the  past  in  prohibiting  such  experiments 
—  would  have  compelled  surgeons  in  1910  to  continue  to 
use  the  same  old,  horrible,  dirty  methods  of  surgery  as  in 
the  days  before  Lister,  and  thus  to  offer  up  hecatombs  of 
human  lives  to  the  Moloch  of  anti vivisection?    Which 

*  For  an  account  of  how  Lister  discovered  and  developed  his  antiseptic 
method  see  the  next  preceding  paper,  p.  199. 


AND  MEDICAL  PROGRESS  227 

method  will  any  man  of  common  sense  or  any  woman  with 
a  human  heart  choose? 

Even  in  surgery  it  is  doubtful  if  a  more  wonderful  im- 
provement has  been  realized  than  in  our  maternity  hospi- 
tals and  in  private  obstetric  practice  as  a  direct  result  of 
the  work  of  Pasteur  and  Lister.  Well  do  I  remember  as  a 
young  man  every  now  and  then  an  outbreak  of  that  fright- 
ful and  fatal  puerperal  or  "  childbed  "  fever  in  our  maternity 
hospitals.  Almost  every  woman  who  then  entered  such  a 
hospital  was  doomed  to  suffer  an  attack  of  the  fever,  and  its 
mortality  sometimes  ran  up  to  seventy-five,  or  even  more, 
out  of  every  hundred  mothers.  Often  such  hospitals  had 
to  be  closed  till  the  then  unknown  poison  disappeared. 
Not  a  few  obstetricians  had  to  quit  practice  entirely  for 
weeks  because  every  woman  they  attended  fell  ill  of  the 
disease  and  many,  many  died.  Finally  Pasteur  appeared  on 
the  field.  In  1879,  in  a  discussion  on  puerperal  fever  at  the 
Paris  Academy  of  Medicine,  after  a  member  had  eloquently 
discussed  various  alleged  causes  of  these  epidemics,  Pasteur 
interrupted  him  and  said:  "All  this  has  nothing  to  do  with 
the  cause  of  these  epidemics.  It  is  the  doctors  who  trans- 
port the  microbe  from  a  sick  woman  to  a  healthy  woman." 
When  the  speaker  responded  that  he  feared  they  would 
never  find  this  microbe,  Pasteur  immediately  advanced  to 
the  blackboard,  drew  the  picture  of  what  we  know  as  the 
"streptococcus"  and  said:  "This  is  the  cause  of  the 
disease."  This  recognition  of  the  streptococcus  as  the  cause 
of  puerperal  fever  and  the  consequent  adoption  of  anti- 
septic methods  have  practically  abolished  puerperal  fever 
and  reduced  the  mortahty  in  maternity  cases  to  less  than 
one  in  a  hundred.* 

All  this  we  owe  absolutely  to  experiment  on  animals. 
Nothing  else  could  have  given  us  the  knowledge.  Even 
the  horrible  experiments  that  were  being  made  by  doctors 

*  For  a  fuller  account  of  the  results  in  childbed  fever  see  the  paper 
on  "  The  Influence  of  Antivivisection  on  Character,"  post,  p.  256. 


228  ANIMAL  EXPERIMENTATION 

who  were  ignorantly  spreading  the  poison  all  around  them, 
even  these  were  not  sufficient  to  open  our  eyes  to  the  real 
cause  of  the  disease.  The  laboratory  test-tubes  and  experi- 
ments on  animals  were  the  chief  means  by  which  this 
scourge  of  motherhood  has  been  banished. 

In  addition  to  all  these,  another  fearful  disease,  yellow 
fever,  has  also  been  abolished  by  experiment  which  was 
necessary  for  the  final  convincing  proof.  I  need  not  repeat 
at  length  the  frightful  ravages  of  this  terrible  pestilence  in 
days  gone  by.  Cuba  was  never  free  from  it  for  nearly  two 
centuries  until  the  American  Commission  showed  how  to 
get  rid  of  it.  The  Panama  Canal  Zone  had  perhaps  the 
worst  reputation  in  the  world  as  a  graveyard  for  strangers, 
and  now  for  four  years  not  a  single  case  of  yellow  fever  has 
originated  there!  Colonel  Gorgas  has  made  the  Panama 
Canal  a  possibihty. 

I  wish  that  every  one  might  read  that  most  interesting 
little  book,  "Walter  Reed  and  Yellow  Fever,"  by  Dr. 
Howard  A.  Kelly,  and  see  the  wonderful  methods  by  which 
this  scourge  of  humanity  has  been  abolished.  When  one 
thinks  of  the  enormous  difficulties  of  the  problem,  the 
wonder  is  that  it  was  ever  solved.  There  are  about  four 
hundred  varieties  of  mosquito.  Only  one  of  them  carries 
the  poison  of  yellow  fever.  Of  this  variety  only  the  female 
carries  the  poison,  and  this  female  mosquito  must  have 
bitten  a  patient  sick  with  yellow  fever  during  the  first  three 
days  of  his  illness,  or  she  could  not  become  infected. 
Moreover,  after  infection,  the  poison,  whatever  it  is,  does 
not  develop  in  the  body  of  the  female  mosquito  for  about 
twelve  days.  Some  of  these  facts  were  thought  to  be  true, 
but  there  was  no  positive  proof.  A  very  large  number, 
perhaps  the  majority,  of  yellow-fever  experts  still  believed 
that  the  disease  was  carried  in  clothing,  bedding,  etc.  To 
disprove  this  experiments  were  tried  first  of  all  by  doctors 
on  themselves.  They  slept  in  the  beds  in  which  yellow- 
fever  patients  had  died,  and  in  their  very  clothes,  night 


AND  MEDICAL  PROGRESS  229 

after  night  —  clothes  soiled  with  their  black  vomit,  urine, 
and  feces.  At  other  times  doctors  have  actually  swallowed 
the  black  vomit,  tried  to  inoculate  themselves  by  putting 
some  of  it  into  their  eyes,  by  hypodermic  injections,  etc., 
in  the  vain  attempt  to  discover  the  cause  of  the  disease 
and  the  means  by  which  it  was  spread,  hoping  in  this  way 
to  discover  the  means  of  preventing  it.  Surely  seK-sacrifice 
could  go  no  farther.  Yes,  it  could  go  farther.  One  more  step 
was  requisite.  The  only  way  to  give  the  absolute  final 
proof  was  for  a  well  man  to  be  bitten  by  a  mosquito  known 
to  be  infected.  Dr.  Carroll,  of  the  United  States  Army,  was 
the  first  one  who  offered  himself.  Other  men  followed  — 
doctors,  soldiers,  and  others.  Several  lost  their  lives, 
among  them  Dr.  Lazear  at  the  beginning  of  a  most  promis- 
ing career.  His  tablet  in  the  Johns  Hopkins  Hospital,  in 
the  fine  words  written  by  President  Eliot,  records  that 
"With  more  than  the  courage  and  the  devotion  of  the 
soldier  he  risked  and  lost  his  life  to  show  how  a  fearful 
pestilence  is  communicated  and  how  its  ravages  may  be 
prevented." 

It  is  often  said  that  such  experimental  work  brutalizes 
men.  Let  us  read  a  letter  from  Dr.  Reed  to  his  wife, 
remembering,  also,  that  the  same  high  and  holy  purposes 
animate  Drs.  Flexner,  Carrel,  Crile,  and  other  experi- 
menters:— 

QuEMADO,  Cuba, 
11.50  P.M.,  December  31,  1900. 

Only  ten  minutes  of  the  old  century  remain.  Here  have  I  been 
sitting,  reading  that  most  wonderful  book,  "LaRoche  on  Yellow 
Fever,"  written  in  1853.  Forty -seven  years  later  it  has  been  per- 
mitted to  me  and  my  assistants  to  lift  the  impenetrable  veil  that 
has  surrounded  the  causation  of  this  most  wonderful,  dreadful 
pest  of  humanity  and  to  put  it  on  a  rational  and  scientific  basis.  I 
thank  God  that  this  had  been  accomplished  during  the  latter  days 
of  the  old  century.  May  its  cure  be  wrought  out  in  the  early  days 
of  the  new !  The  prayer  that  has  been  mine  for  twenty  years,  that 
I  might  be  permitted  in  some  way  or  at  some  time  to  do  something 
to  alleviate  human  suffering,  has  been  granted! 


9S0  ANIMAL  EXPERIMENTATION 

This  prayer  of  Reed  —  that  its  cure  might  be  wrought 
out  in  the  new,  the  twentieth  century  —  has  been  abun- 
dantly realized  and  yellow  fever  is  now  a  vanquished  foe. 

Unfortunately,  the  lower  animals  cannot  be  infected 
with  yellow  fever.  If  they  could  be,  Lazear  and  the  other 
victims  would  have  been  saved.  But  they,  yielding  up 
their  lives  as  leaders  of  a  forlorn  hope  in  the  battle  against 
disease,  have  made  it  possible  to  free  the  world  from  this 
dreadful  scourge.  Never  was  there  a  finer  exhibition  of 
courage! 

The  antivivisectionists  have  never  dared  to  attack  these 
experiments  upon  man.  If  they  had  dared  to  do  so,  pub- 
lic opinion  would  have  made  short  work  of  them. 

A  few  years  ago  I  was  called  to  Annapolis  to  see  a  young 
man  who  had  been  injured  in  a  football  game.  He  was 
evidently  swiftly  going  to  his  grave.  He  had  certain 
peculiar  symptoms,  which,  in  the  light  of  cerebral  localiza- 
tion —  that  is,  the  fact  that  certain  definite  portions  of  the 
surface  of  the  brain  have  each  a  certain  definite  function  — 
I  believed  to  be  due  to  a  clot  of  blood  inside  of  his  head 
above  his  left  ear.  There  was  a  bruise,  not  above  the  ear, 
but  at  the  outer  end  of  the  left  eyebrow.  Before  1885  I 
should  have  opened  his  skull  under  the  bruise,  —  appar- 
ently the  almost  certain  point  of  injury,  —  would  have 
failed  to  find  the  clot,  and  he  would  surely  have  died. 
Instead  of  this  I  made  a  trap-door  opening  three  inches 
away  from  this  bruise,  removed  nine  tablespoonfuls  of 
clotted  blood,  closed  the  wound  so  that  his  skull  was  as 
firm  as  ever,  and  he  recovered,  continued  his  studies,  was 
graduated  from  the  Naval  Academy.  Lately  he  has 
heroically  given  up  his  life  at  the  call  of  duty.  Had  it  not 
been  for  experiments  on  animals  which  had  definitely  fixed 
certain  spots  in  the  brain  as  the  centers  for  movements  of 
the  hand,  arm,  shoulder,  head,  face,  etc.,  it  would  have 
been  utterly  impossible  for  me  to  save  his  life.  This  is  but 
one  of  hundreds  of  similar  cases  in  which  modern  surgery 


AND  MEDICAL  PROGRESS  231 

deals  with  tumors  of  the  brain,  hemorrhage  inside  of  the 
skull  and  many  other  disorders,  and  deals  with  them 
successfully.^ 

I  have  heard  the  following  pitiful  story  from  one  of  my 
colleagues.  He  and  a  young  mother  stood  by  the  bedside 
of  her  only  child.  The  child,  in  the  throes  of  diphtheria, 
was  clutching  at  its  throat  and  gasping  vainly  for  breath. 
Suddenly  the  mother  flung  herself  on  the  floor  at  the  doc- 
tor's feet  in  an  agony  of  tears,  entreating  him  to  save  her 
child.  But  alas !  it  was  impossible.  Had  this  case  occurred 
a  few  years  later,  however,  when  the  blessed  antitoxin  for 
diphtheria  had  been  discovered  (solely  by  animal  experi- 
mentation), this  remedy  would  have  been  given  early;  and 
almost  certainly  within  a  few  hours  the  membrane  would 
have  softened  and  disappeared,  and  that  life,  precious 
beyond  rubies,  might  have  been  saved. 

In  those  early  dreadful  days  the  only  comfort  we  could 
give  such  distracted  mothers  —  possibly  some  of  them  may 
read  these  very  lines  —  was  that  "it  was  God's  will."  Yes! 
Then,  possibly,  it  was  God*s  will;  but  now,  thank  God,  it  is 
not  His  will.  One  might  as  well  say  it  is  God's  will  that 
thousands  should  die  from  smallpox  when  vaccination  will 
protect  them;  that  other  thousands  should  die  from  typhoid 
fever  when  a  pure  water-supply  and  the  banishment  of  the 
fly  will  prevent  it;  that  thousands  of  women  should  die 
from  puerperal  fever  when  sterile  hands  and  sterile  instru- 
ments will  save  them! 

Let  me  give  a  table  of  some  official  reports  showing  in 
nineteen  American  and  European  cities  the  mortality  in 
every  one  hundred  thousand  inhabitants  from  diphtheria 
in  1894  —  that  is  to  say,  before  the  use  of  the  antitoxin  of 
diphtheria  —  and  in  1905,  when  its  use  had  become  gen- 
eral. Being  official  and  from  nineteen  cities  in  America 
and  Europe,  its  accuracy  can  hardly  be  assailed, 

*  See  "Midshipman  Aiken  and  Vivisection,"  ante,  p.  146,  for  a  fuller 
account  of  this  case. 


232  ANIMAL  EXPERIMENTATION 

Table  of  Mortality  from  Diphtheria 

Per  100,000  Inhabitants 
1894  1905 

New  York 158  88 

Philadelphia 128  32 

Baltimore 50  20 

Boston 180  22 

Brooklyn 173  43 

Pittsburg 64  26 

London 66  12.2 

Paris 40  6 

Vienna 114  19 

These  nine  and  ten  other  large  cities  taken  together 
average  as  follows;  in  1894,  79.9,  and  in  1905,  19,  per 
100,000  inhabitants  —  that  is  to  say,  in  these  nineteen 
cities  the  average  death-rate  in  1905  was  less  than  one 
fourth  of  the  rate  before  the  introduction  of  the  serum 
treatment. 

The  alleged  atrocities  so  vividly  described  in  antivivi- 
section  literature  are  fine  instances  of  "yellow  journalism," 
and  the  quotations  from  medical  men  are  often  misleading. 
Thus,  Sir  Frederick  Treves,  the  eminent  English  surgeon, 
is  quoted  as  an  opponent  of  vivisection  in  general.  In 
spite  of  a  denial  published  seven  years  ago,  the  quotation 
still  does  frequent  duty.  I  know  personally  and  intimately 
Horsley,  Ferrier,  Carrel,  Flexner,  Crile,  Gushing  and  others, 
and  I  do  not  know  men  who  are  kinder  and  more  lovable. 
That  they  would  be  guilty  of  deliberate  cruelty  I  would  no 
more  believe  than  that  my  own  brother  would  have  been. 

Moreover,  I  have  seen  their  experiments,  and  can  vouch 
personally  for  the  fact  that  they  give  to  these  animals 
exactly  the  same  care  that  I  do  to  a  human  being.  Were 
it  otherwise  their  experiments  would  fail  and  utterly 
discredit  them.  Whenever  an  operation  would  be  painful 
an  anesthetic  is  always  given.  This  is  dictated  not  only 
by  humanity,  but  by  two  other  valid  considerations :  first, 


AND  MEDICAL  PROGRESS  233 

long  and  delicate  operations  cannot  be  done  properly  on 
a  struggling,  fighting  animal  any  more  than  they  could  be 
done  on  a  struggling  fighting  human  being,  and  so  again 
their  experiments  would  be  failures;  and  second,  should 
any  one  try  an  experiment  without  giving  ether  he  would 
soon  discover  that  dogs  have  teeth  and  cats  have  claws. 
Moreover,  it  will  surprise  many  of  my  readers  to  learn  that 
of  the  total  number  of  experiments  done  in  one  year  in 
England  ninety-seven  per  cent  were  hypodermic  injections 
and  only  three  per  cent  could  be  called  painfull 

If  any  one  will  read  the  report  of  the  recent  British 
Royal  Commission  on  Vivisection,  "he  would  find,"  says 
Lord  Cromer,  "that  there  was  not  a  single  case  of  extreme 
and  unnecessary  cruelty  brought  forward  by  the  Antivivi- 
section  Society  which  did  not  hopelessly  break  down  under 
cross-examination/  *  ^ 

In  view  of  what  I  have  written  above  —  and  many 
times  as  much  could  be  added  —  is  it  any  wonder  that 
I  believe  it  to  be  a  common-sense,  a  scientific,  a  moral, 
and  a  Christian  duty  to  promote  experimental  research? 
To  hinder  it,  and,  still  more,  to  stop  it  would  be  a  crime 
against  the  human  race  itself,  and  also  against  animals, 
which  have  benefited  almost  as  much  as  man  from  these 
experiments. 

What  do  our  antivivisection  friends  propose  as  a  substi- 
tute? Nothing  except  clinical  —  that  is,  bedside  —  and 
post-mortem  observations.  These  have  been  in  use  for  two 
thousand  years  and  have  not  given  us  results  to  be  com- 
pared for  a  moment  with  the  results  gained  by  experimental 
research  in  the  last  fifty,  or  even  the  last  twenty-five  years. 

For  a  tabular  contrast  between  the  beneficent  results  of 
experimental  research  and  the  utter  futile  results  of  the 
years  of  agitation  by  the  antivivisectionists,  see  post,p.  280. 

1  See  the  statements  and  Resolutions  on  pp.  xv-xviii.  ^ 


THE  INFLUENCE  OF  ANTIVIVISECTION  ON 
CHARACTER! 

"  In  this  controversy  [vivisection]  there  should  be  no  bitter- 
ness. .  .  .  Do  not  let  us  attempt  to  browbeat  or  call  names.  .  .  . 
Vivisection  tends  to  weaken  character.  .  .  .  Nothing  which  hurts 
the  character  can  be  right.*'  (Rev.  Dr.  Floyd  W.  Tomkins,  Presi- 
dent of  the  American  Antivivisection  Society,  in  the  Ladies*  Home 
Journal,  March,  1910.) 

I  ACCEPT  the  test  proposed  by  Dr.  Tomkins,  and  quoted 
in  the  above  motto,  "Nothing  which  hurts  the  character 
can  be  right.*'  Let  us,  therefore,  study  what  is  the  effect 
of  antivivisection  on  the  character  of  its  advocates. 

7.  Violent  Passions  aroused  by  Antivivisection  Agitation 

The  most  violent  and  vindictive  passions  have  been 
aroused  and  fostered,  especially  among  women  —  the  very- 
flower  of  our  modern  civilization.  Let  us  see  whether  they 
have  shown  "bitterness"  or  "called  names."  I  have 
rejected  much  oral  testimony  I  could  use  and  have  drawn 
my  evidence  from  only  a  very  small  portion  of  the  literature 
at  my  disposal. 

Herewith  I  reproduce  (Fig.  1)  the  photograph  of  a 
remarkable  letter  which  contains  an  asserted  prayer  to 
the  Deity  calling  down  curses  by  "a  dozen  women"  on 
my  long-since  sainted  mother.  It  needs  no  comment  from 
me  save  that  the  "horror"  mentioned  in  this  letter  was 
excited  by  an  article  which  I  published  in  the  "Ladies* 
Home  Journal"  for  April,  1910,  in  which  I  recited  a  few  of 
the  benefits  to  humanity  which  had  resulted  from  vivisec- 

*  An  address  read  before  the  Surgical  Section  of  the  Suffolk  District 
Medical  Society,  Boston,  March  20,  1912.  Reprinted  by  the  kind  per- 
mission of  the  editor  and  the  publisher  from  the  Boston  Medical  and 
Surgical  Journal^  May  2  and  9,  1912. 


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236  ANIMAL  EXPERIMENTATION 

tion.  The  only  clue  even  to  the  place  from  which  the  letter 
comes  is  the  postmark,  "Los  Angeles." 

Let  me  quote  another  earlier  anonymous  letter  I  have 
before  me.  This  is  from  Philadelphia.  Instead  of  the  usual 
address,  "Dear  Sir,"  it  begins,  "You  Fiend."  I  had  not 
then  been  promoted  to  "Arch-fiend"  in  Satan's  hierarchy. 
The  writer  exclaims,  "  Oh,  that  you  all  could  be  put  through 
the  same  torture  that  you  inflict  on  these  helpless  ones." 
As  I  am  not  a  vivisectionist  this  ardent  wish  fails  to  terrify. 
I  am  an  advocate  of  vivisection  because  I  know  how  greatly 
it  has  helped  me  during  all  my  professional  life  in  saving 
life  and  lessening  suffering.^ 

1  In  the  American  Journal  of  the  Medical  Sciences  for  July,  1865,  p.  67, 
Dr.  S.  Weir  Mitchell,  the  late  Dr.  Morehouse,  and  I  published  a  paper  on 
the  "Antagonism  of  Atropia  and  Morphia,"  based  on  observations  and 
experiments  in  the  Army  Hospital  for  Injuries  and  Diseases  of  the  Nerv- 
ous System.  The  reason  which  caused  us  to  make  this  investigation  was 
that  we  desired  to  find  better  means  for  "soothing  the  pain  of  those  ter- 
rible cases  of  neuralgia"  following  gunshot  wounds  of  large  nerves.  These 
are  accurately  described  in  the  paper  as  causing  "anguish"  and  "agony" 
—  no  word  could  be  too  strong.  "A  Hell  of  Pain"  was  the  accurately 
descriptive  title  one  patient  gave  to  our  hospital.  These  patients  often 
wore  cotton  gloves  and  high  boots  and  always  carried  in  their  pockets  a 
bottle  of  water  which  they  poured  from  time  to  time  on  their  gloves  and 
into  their  boots,  since  the  least  dry  friction  was  simply  intolerable. 

Accordingly,  in  our  efforts,  we  tried  a  number  of  common  and  some 
uncommon  drugs,  and  finally  found  that  morphin  (the  active  principle  of 
opium)  was  the  best  remedy  and  yet  had  many  disadvantages.  Ulti- 
mately we  found  that  by  combining  with  it  a  certain  amount  of  atropin 
(the  active  principle  of  belladonna)  we  obtained  the  best  results.  The 
facts  discovered  in  our  investigations  have  long  since  become  merged  in 
the  common  knowledge  of  the  profession,  and  standard  tablets  with  differ- 
ent proportions  of  the  two  drugs  are  manufactured  and  used  all  over  the 
world.  Most  of  our  patients  operated  on  (entirely  by  hypodermic  injec- 
tions) were  sorely  in  need  of  relief.  A  few  were  convalescents.  In  all  cases 
we  avoided  telling  them  what  drug  was  being  used,  for  every  one  knows 
how  imagination,  fear,  or  other  emotion  would  alter  the  rate  of  the  pulse 
or  of  the  breathing.  Not  one  man  was  injured  in  the  least.  Not  one  ever 
complained.  Since  then  many  thousands  of  human  beings  have  been 
greatly  benefited  and  many  lives  have  been  saved  through  the  knowl- 
edge thus  obtained. 

I  have  expressly  mentioned  these  facts  in  some  detail  because  we  have 
been  attacked  in  their  pamphlets  by  the  antivivisectionists  for  these 


AND  MEDICAL  PROGRESS  237 

If  two  letters  will  not  convince,  here  is  a  third.  This, 
from  Baltimore,  also  the  result  of  the  same  article,  was 
from  a  writer  who  had  the  courage  to  sign  her  name  and 
address :  — 

You  would  appear  even  the  more  fiendish  on  account  of  your 
superior  intelligence.  .  .  .  The  future  of  a  vivisectionist  is  a  veri- 
table hell.  You,  I  understand,  are  a  man  advanced  in  years  [the 
calendar,  alas!  seems  to  justify  this  shocking  statement]  soon  to 
go  before  the  bar  of  justice.  Can  you  meet  your  God  with  the 
terrible  cries  ringing  in  your  ears  of  these  creatures,  our  helpless 
brothers,  made  by  his  hand,  that  you  have  drawn  and  quartered? 
How  they  must  haunt  you.  .  .  .  When  your  time  comes  to  die, 
every  cry  of  pain  and  anguish  that  you  have  been  the  cause  of 
producing  in  these  helpless  creatures  will  follow  you  to  the  depths 
of  heU. 

Yet  I  have  "drawn  and  quartered"  not  even  so  much  as 
a  mouse. 

But  this  same  lady  tells  me  that  she  had  survived  one 
of  the  most  serious  abdominal  operations  that  could  be 
done  —  a  hysterectomy. ^  This  operation  was  so  perilous 
that  until  Lister  had  devised  the  antiseptic  method  it 
was  never  even  thought  possible,  and  its  success  at  the 
present  day  is  due  chiefly  to  experiment  on  animals.  The 
writer  of  the  letter,  therefore,  is  herseK  a  witness  to  the 
benefit  of  vivisection. 

Later  on  she  says,  "If  they  would  only  use  vivisectors 
for  their  experiments,  it  would  soon  be  considered  unneces- 
sary." Her  gentlest  wish,  therefore,  is  for  human  vivisec- 
tion, and  doubtless  "without  anesthetics."  Per  contra, 
in  the  newspapers  of  May  6,  1911,  a  dispatch  states  that 
seventeen  medical  students  had  offered  themselves  for 
experimental  inoculation  with  cancer,  an  offer  which  was, 
of  course,  refused,  as  animals  can  be  used. 

experiments,  which  are  described  as  "Human  Vivisection."  What  would 
they  have  had  us  do?  Sit  idly  by  and  let  these  poor  fellows  suffer  tor- 
ments because  if  we  tried  various  drugs  we  were  "experimenting"  on 
human  beings? 

1  Removal  of  the  entire  womb. 


238  ANIMAL  EXPERIMENTATION 

A  curious  statement  in  the  letter  is,  "I  understand  the 
Rockefeller  Institute  has  had  four  or  five  of  its  laboratories 
burned,  the  animals  destroyed,  rather  than  have  them  fall 
into  the  hands  of  these  wretches,  and  if  this  thing  were 
more  widely  known,  every  medical  college  in  the  country 
would  be  razed  to  the  ground  and  the  doctors  tarred  and 
feathered."  The  insurance  companies,  I  am  quite  certain, 
have  never  heard  of  the  one  laboratory  which  the  Rocke- 
feller Institute  possesses  having  been  burned.  But  what 
a  strange  exhibition  of  kindness  it  is  to  gloat  over  the  fact 
that  the  poor  animals  in  these  supposed  laboratories  had 
been  roasted  to  death  "without  anesthetics." 

If  three  instances  are  not  sufficient,  here  is  a  fourth  — 
a  signed  letter  from  Chicago.  Referring  to  one  case  which 
I  had  published  as  an  illustration  of  the  value  of  vivisection 
in  saving  human  life,  she  says,  "My  sympathy  for  the 
parents  of  that  young  man  .  .  .  would  have  been  deep, 
but  not  so  keen  as  for  a  mother  dog  who  saw  her  puppy 
tortured  to  death  on  a  dissecting  table.  .  .  .  Even  if  you 
did  save  a  man's  life,  was  it  worth  while  f^*  (Italics  in  the 
letter!)  This  lady  wrongly  assumes  that  the  puppy  was 
"tortured  to  death,"  i.e.,  without  anesthetics.  This,  I  am 
glad  to  say,  is  not  true,  as  I  shall  show  later  on.  To  her 
question,  "Was  it  worth  while?"  I  can  only  say,  "Ask 
his  father  and  mother." 

And  this  is  the  ennobUng  influence  of  anti vivisection! 

A  fifth  communication  is  from  a  lady  who  was  person- 
ally acquainted  with  myself  and  my  family.  She  sent  me  a 
pamphlet  with  some  good  advice,  ending  with  the  terse 
injunction,  "Do  God's  work,  not  the  Devil's,"  and  had 
the  courage  to  sign  her  name. 

A  sixth  lady  sent  me  (anonymously)  an  article  from  one 
of  our  magazines,  with  many  marginal  annotations  and 
much  underscoring.  From  this  I  select  a  few  sentences. 

Millions  of  people  regard  him  [the  vivisector]  with  loathing,  and 
shudder  with  horror  at  his  name.  .  .  .  Frightful  as  the  suffer- 


AND  MEDICAL  PROGRESS  239 

ings  of  this  tortured  dog  must  be,  I  would  rather  be  in  its  place 
than  yours  when  your  soul  is  summoned  to  its  final  judgment  to 
receive  judgment  without  mercy.  [This  seems  to  be  a  favorite 
threat  of  my  correspondents.]  May  God  so  deal  with  every  fiend 
incarnate  who  has  thus  tortured  defenseless  creatures.  .  .  .  All 
the  demons  and  fiends  do  not  dwell  in  Hades.  Some  are  made  in 
the  image  of  God,  but  have  hearts  blacker  and  more  cruel  than 
the  arch-fiend  himself.  These  are  the  vivisectors  who  "benefit" 
mankind. 

I  have  received  very  many  more  such  letters  —  usually 
anonymous.  These  six  may  serve  as  samples. 

I  would  willingly  accept  the  supposition  of  unbalanced 
minds  as  an  explanation  and  palliation  for  such  letters 
but  for  their  number  and  for  the  fact  that  they  so  entirely 
coincide  with  almost  all  the  "repulsive  literature"  (to  use 
Lord  Coleridge's  words)  published  by  the  various  antivivi- 
section  societies. 

A  brief  search  through  only  a  part  of  my  file  of  this 
antivivisection  literature  enables  me  to  cull  the  following 
evidences  of  a  similar  debasing  violence  and  vindictive- 
ness.   The  list  could  easily  be  extended. 

The  art  of  torture  has  been  carried  to  a  perfection  which  the 
devildoms  of  Spain  in  the  old  days  of  the  Inquisition  could  not 
equal  in  ingenuity  or  pitilessness. 

Vivisection  is  the  anguish,  the  hell  of  science.  All  the  cruelty 
which  the  human  or  rather  the  inhuman  heart  is  capable  of 
inflicting  is  in  this  one  word.  Below  it  there  is  no  depth.  This 
word  lies  like  a  coiled  serpent  at  the  bottom  of  the  abyss. 

Animals  are  dissected  alive  —  usually  without  the  use  of  anes- 
thetics. 

The  vivisector  keeps  his  victim  alive  while  he  cuts  it  up. 

Vivisection  founded  on  cruelty,  supported  by  falsehood,  and 
practiced  for  selfish  ends. 

The  vivisector  is  less  valuable  to  the  world  than  the  animals  he 
destroys. 

A  thing  I  know  to  be  damnable  whatever  the  results. 

An  organized  system  of  barbarity. 

Vivisector  and  criminal  become  interchangeable  terms. 

Cowards  who  perpetrate  hideous  crimes. 


240  ANIMAL  EXPERIMENTATION 

Experiments  on  living  animals  is  a  system  of  long-protracted 
agonies,  the  very  recollection  of  which  is  enough  to  make  the  soul 
sick  as  if  with  a  whiflF  and  an  after-taste  of  a  moral  sewer. 

Impious  barbarity  of  the  vivisector. 

All  other  forms  of  sinful  cruelty  are  comparatively  trifling  com- 
pared with  the  horrors  of  vivisection. 

Deliberate  dabbling  in  blood  and  agony. 

Cruelty  the  inevitable  and  odious  spawn  of  secret  vivisection. 

Blood-stained  hands  of  the  grim  tormentors. 

Bloody  mass  of  agony. 

Devilish  inventions  of  unbalanced  mentality. 

At  a  hearing  before  a  committee  of  the  Legislature  of 
Pennsylvania,  I  heard  myself  and  others  who  were  advo- 
cating the  humane  work  of  vivisection  called  "hyenas"  by 
a  woman. 

Briefer  descriptive  terms  are  as  follows :  — 

scientific  hells  temples  of  torment 

torture-house  cruelty  of  cruelties 

orgy  of  cruelty  infernal  work 

halls  of  agony  hellish  wrong 

inhuman  devil  devil's  work 

devils  incarnate  lust  of  cruelty 

scientific  murder  scientific  assassination 

abominable  sin  torture  of  the  innocent 

devilish  science  black  art  of  vivisection 

fiends  incarnate  satanic 

damnably  mean  fiends 

arch-fiend  human  monsters 

master  demon  demons 

diabolical  vivisection  working  model  of  hell 

Antivivisection  writers  nearly  always  state,  assume,  or 
imply  that  all  experiments  are  "tortures,"  i.e.,  that  anes- 
thetics are  not  used.  This  is  wholly  erroneous. 

In  Great  Britain,  where  all  experiments  are  returned  to 
the  Government,  the  following  table  for  1906  (the  latest  I 
happen  to  have)  will  show  how  utterly  indefensible  is  such 
an  assumption.  It  is  a  fair  presumption  that  about  the 
same  average  exists  in  the  United  States. 


AND  MEDICAL  PROGRESS  241 

Per  cent. 

Inoculations,  etc.,  not  involving  any  operation 93.96 

Animals  killed  under  anesthetics 3.44 

Animals  allowed  to  recover  from  anesthetic  but  nothing  likely  to 
cause  pain  and  no  further  operation  allowed  without  anesthetic        2.60 

100.00 

In  other  words,  only  twenty-six  animals  out  of  one  thou- 
sand could  by  any  possibility  have  suffered  any  pain,  and 
very  few  of  these  any  serious  pain.  Is  this  the  torture  and 
agony  so  constantly  harped  on? 

[Since  this  address  was  delivered  the  report  of  the  British 
Royal  Commission  on  Vivisection,  on  which  the  antivivi- 
sectionists  were  represented,  has  appeared.  One  of  their 
unanimous  conclusions  (page  20)  is  as  follows :  — 

**We  desire  to  state  that  the  harrowing  descriptions  and 
illustrations  of  operations  inflicted  on  animals,  which  are 
freely  circulated  by  post,  advertisement,  or  otherwise,  are  in 
many  cases  calculated  to  mislead  the  public,  so  far  as  they 
suggest  that  the  animals  in  question  were  not  under  an 
anesthetic.  To  represent  that  animals  subjected  to  experi- 
ments in  this  country  are  wantonly  tortured  would,  in  our 
opinion,  be  absolutely  false.'* 

This  clear  statement  should  end  this  calumny.] 

Many  of  the  instances  cited  in  antivivisection  literature 
are  taken  from  researches  —  such  as  Magendie's  —  which 
were  made  before  anesthetics  were  discovered,  over  sixty- 
five  years  ago. 

The  rest  in  which  real  cruelty  was  inflicted,  and  which  if 
done  now  would  be  condemned  by  all  modern  research 
workers  as  freely  as  by  the  antivivisectionists  themselves, 
were  done  almost  wholly  on  the  Continent,  and  often  by 
persons  who  are  now  dead.  In  discussing  vivisection  to-day, 
these  should  be  excluded,  or  their  dates  and  countries 
indicated,  for  the  public,  ignorant  of  medical  history,  is 
misled  into  supposing  that  these  persons  are  living  and 
practicing  these  methods  to-day  and  in  America. 


242  ANIMAL  EXPERIMENTATION 

In  one  of  the  anonymous  replies  to  my  paper  on  the 
**  Misstatements  of  Antivivisectionists,"  ^  I  am  represented 
as  the  apologist  and  advocate  of  experiments  of  which 
twice  over  at  the  Senate  Committee  hearing  and  again  in 
my  letter  to  Mr.  Brown  I  had  expressed  my  utter  dis- 
approval. I  am  always  willing  to  face  a  truthful  charge, 
but  it  is  a  hopeless  task  to  meet  untruthful  charges, 
especially  when  the  author  is  ashamed  of  his  own  name. 

"Hell  at  Close  Range"  is  the  title  given  by  Miss  Ellen 
Snow  to  a  leaflet  dealing  with  the  work  of  the  Rockefeller 
Institute.  One  could  scarcely  expect  such  fierce  heat  from 
so  frosty  a  name. 

At  this  institute,  by  experiments  on  twenty-five  monkeys 
and  one  hundred  guinea-pigs,  most  of  which  animals  re- 
covered, has  been  discovered  a  serum  that  has  brought 
the  former  death-rate  of  cerebro-spinal  meningitis  of 
seventy-five  or  ninety  per  cent  down  to  twenty  per  cent 
and  less.  Is  it  because  of  this  beneficent  work  that  it  is 
caUed  "hell".? 

At  this  institute  has  been  discovered  a  means  of  trans- 
fusion of  blood  that  has  already  saved  scores  of  human 
lives.  Is  this  the  reason  for  calling  it  "hell"? 

At  this  institute  a  method  of  criss-crossing  arteries  and 
veins,  which  almost  always  run  alongside  of  each  other, 
has  been  discovered  by  which  impending  gangrene  has 
been  prevented.  Does  this  make  it  a  "hell"? 

At  this  institute  the  cause  and  the  cure  of  infantile 
paralysis  are  being  sought.  Are  such  investigations  carried 
on  in  "hell"?  2 

Miss  Snow  in  this  same  leaflet  expresses  in  italics  her 
horror  at  the  idea  of  the  proposition  of  the  institute  "  to 
build  a  hospital  where  the  experiments  may  be  continued 
on  human  beings."  It  may  be  of  interest  to  her  and  also 

1  Ante,  p.  110. 

2  Since  this  was  written  the  germs  of  infantile  paralysis  and  of  hydro- 
phobia have  been  discovered  at  this  same  institute. 


AND  MEDICAL  PROGRESS  243 

to  others  to  know  that  this  hospital  was  opened  in  October, 
1910,  and  that  the  public,  undeterred  by  her  horror,  have 
thronged  to  it  in  such  numbers  that  there  have  not  been 
beds  enough  for  the  several  hundreds  of  disappointed 
applicants. 

An  editorial  in  the  "Journal  of  Zoophily  "  ^  records  a  gift 
to  this  Rockefeller  Institute,  "an  institution  in  New  York 
where  vivisection  should  be  practiced  with  the  idea  of 
achieving  as  great  an  advance  as  possible  in  the  war  of 
science  against  human  suffering,"  and  adds,  "but  the  gift 
only  fanned  into  fury  the  opposition  of  the  women  to 
experiments  on  living  animals,  no  matter  how  great  the  antici- 
pated benefit,''  Could  cruel  passion  be  better  expressed? 

Can  a  cause  which  so  seriously  injures  the  character 
of  its  advocates  that  they  indulge  in  this  proHfic  vocabu- 
lary of  vituperation  by  any  possibility  have  an  uplifting 
influence?  It  eminently  fulfills  Dr.  Tomkins'  proposed  test 
—  it  "hurts  the  character  and,  therefore,  cannot  be  right." 

Are  those  who  give  loose  rein  to  such  passion  fitted  to 
form  a  sound  and  sane  judgment  on  the  subject  about 
which  they  write?  This  is  especially  true  when  the  matter 
is  one  so  technical  as  anatomic,  physiologic,  chemical, 

1  Jour,  of  Zoophily,  January,  1909,  p.  2. 

In  my  opinion  other  antivivisection  journals  are  not  worth  the  time  or 
the  money,  but  this  one  —  the  Journal  of  Zoophily  —  is  my  stand-by. 
Of  course  its  columns,  like  those  of  all  its  tribe,  are  filled  with  much  fic- 
tion, but  it  often  reminds  me  of  the  good-humored  epigram  of  a  witty 
husband  to  his  wife,  "My  dear,  you  are  usually  wrong,  but  you  are 
never  dull."  Its  annual  tome  of  somewhat  over  two  hundred  pages  re- 
quires the  combined  energies  of  four  editors,  beginning  with  the  hyphen- 
ated "Editor-in-Chief."  It  outshines  the  "Outlook"  now  for  it  still  has 
a  "Contributing  Editor,"  who,  with  becoming  dignity,  contributes  only 
on  special  occasions.  Its  price  is  "one  dollar  per  annum"  —  only  twenty- 
five  cents  per  editor!  For  shame! 

Its  oflSce  is  just  around  the  corner  from  my  house.  Among  a  swarm  of 
florists'  and  opticians'  and  other  shops,  it  is  our  sole  literary  attraction. 
Appropriately  also  it  is  very  neighborly.  It  raps  on  my  door  each  month 
(though  generally  sadly  belated)  and  whenever  I  wander  too  far  from  the 
path  of  virtue,  it  also  raps  on  my  head.  I  find  it  very  entertaining. 


244  ANIMAL  EXPERIMENTATION 

pathologic  and  surgical  investigations  as  to  which  they 
cannot  be  expected  to  know  and,  in  fact,  do  not  know 
anything.  Even  relatively  few  medical  men  are  fitted 
by  temperament  and  training  to  act  as  censors  of  such 
researches,  much  less  those  ignorant  of  medicine. 

I  believe  that  much  of  the  passion  shown  in  the  above 
quotations  is  the  result  of  ignorance.  Most  of  the  attacks 
on  vivisection,  as  I  have  said,  assume  or  even  state  cate- 
gorically that  anesthetics  are  not  used.  Saving  in  the  very 
rare  cases  in  which  the  use  of  anesthetics  would  entirely 
frustrate  the  experiment,  anesthetics  are  always  used. 
This  is  done  not  only  for  reasons  of  humanity,  but  also 
because  the  struggles  of  a  suffering  animal  would  make 
delicate  and  difficult  operations  absolutely  impossible,  to 
say  nothing  of  the  danger  of  injury  to  the  operator. 

The  always-quoted  opinion  of  Professor  Bigelow  was 
founded  on  what  he  had  seen  at  the  Veterinary  School  at 
Alfort,  France,  in  the  pre-anesthetic  days.  (See  p.  278.) 

Many  absolutely  false  statements  are  made  that  anes- 
thetics were  not  used  in  certain  specified  experiments, 
whereas  the  experimenters  have  expressly  stated  that 
anesthetics  were  used.  Of  such  misstatements  by  antivivi- 
section  authors  I  shall  give  some  startling  instances  later. 
It  is  no  wonder  that  the  public  has  been  thus  misled. 
"Cutting  up  men  and  women  alive"  is  an  accurate  descrip- 
tion of  every  surgical  operation,  but  we  all  know  that  while 
in  comparatively  few  reports  of  surgical  operations  it  is 
expressly  stated  that  an  anesthetic  was  used,  such  use 
"goes  without  saying.'* 

One  of  the  most  frequent  antivivisection  statements 
is  that  "incomplete"  or  "slight"  or  "light"  anesthesia 
means  that  the  animal  is  fully  able  to  feel  pain  and  that 
when  the  eye  resents  a  touch  or  there  is  muscular  move- 
ment following  any  act  which  would  be  painful  when  one 
is  not  anesthetized,  pain  is  actually  being  inflicted. 
Mr.  Coleridge  says   (Question  10,387  in  his  testimony 


AND  MEDICAL  PROGRESS  245 

before  the  Second  Royal  Commission  on  Vivisection), 
"What  does  *  anesthetized'  mean?  It  means  'without 
feeling.'  You  cannot  be  slightly  without  feeling.  You 
either  feel  pain  or  you  do  not." 

Very  recently  when  I  had  nitrous  oxid  gas  given  several 
times  to  a  lady  to  bend  a  stiff  elbow  she  struggled  and 
writhed  so  hard  as  almost  to  throw  herself  out  of  the  den- 
tist's chair  on  to  the  floor.  Yet  she  was  never  conscious  of 
the  slightest  pain.  In  other  words,  while  the  motor  nervous 
centers  responded  to  my  forcible  bending  movements  and 
caused  violent  muscular  struggles,  the  perceptive  nervous 
centers  felt  no  pain.  But  any  spectator  would  surely  have 
said  that  she  was  being  "tortured."  This  is  only  one  of 
hundreds  of  similar  cases  I  have  had;  all  other  surgeons 
have  had  similar  experiences. 

In  modern  laboratory  researches,  ether  or  other  anes- 
thetics are  almost  always  given.  Extremely  few  exceptions 
occur,  and  then  only  with  the  consent  of  the  director  in 
each  specific  case.  The  actual  conditions  at  the  present 
day  are  well  shown  by  the  rules  in  force  in  practically  all 
American  laboratories  of  research.  These  rules  have  been 
in  operation  for  over  thirty  years  in  one  case  and  for  more 
than  ten  years  in  others.  In  most  laboratories  in  which 
students  work,  and  where  they  are  absolutely  under  the 
control  of  the  director,  the  only  animal  used  is  the  frog, 
and  by  "pithing"  or  decapitating  it,  it  is  made  wholly 
insensible  to  pain. 

The  idea  that  students  privately  "torture"  animals, 
often,  it  is  stated,  out  of  mere  curiosity,  is  absolutely 
false.  I  have  been  intimately  associated  with  students 
ever  since  1860,  first  as  a  student  and  since  1866  as  a 
teacher.  I  state,  therefore,  what  I  am  in  a  position  to 
know.  Moreover,  private  experimental  research  takes 
time  which  our  overworked  students  do  not  have,  and 
money  which  they  cannot  afford.  It  means  the  rent  of 
a  laboratory,  the  purchase  of  very  expensive  and  delicate 


246  ANIMAL  EXPERIMENTATION 

instruments,  the  rent  of  an  animal  room,  the  cost  of  the 
animals,  and  of  their  food  and  care,  a  man  to  look  after 
them,  —  for  all  modern  surgical  work  on  animals  must 
be  done  with  the  same  strict  antiseptic  care  as  on  man 
or  the  experiment  will  surely  fail  and  discredit  the  author, 
—  a  total  expense  amounting  to  a  very  large  sum. 

I  quote  in  full  the  rules  which,  as  I  have  said,  are  in 
force  in  practically  all  American  laboratories  of  research: — 

Rules  Regarding  Animals 

1.  Vagrant  dogs  and  cats  brought  to  this  laboratory  and  pur- 
chased here  shall  be  held  at  least  as  long  as  at  the  city  pound,  and 
shall  be  returned  to  their  owners  if  claimed  and  identified. 

2.  Animals  in  the  laboratory  shall  receive  every  consideration 
for  their  bodily  comfort;  they  shall  be  kindly  treated,  properly 
fed,  and  their  surroundings  kept  in  the  best  possible  sanitary  con- 
dition. 

3.  No  operations  on  animals  shall  be  made  except  with  the 
sanction  of  the  director  of  the  laboratory,  who  holds  himself 
responsible  for  the  importance  of  the  problems  studied  and  for 
the  propriety  of  the  procedures  used  in  the  solution  of  these 
problems. 

4.  In  any  operation  likely  to  cause  greater  discomfort  than  that 
attending  anesthetization,  the  animal  shall  first  be  rendered 
incapable  of  perceiving  pain  and  shall  be  maintained  in  that  con- 
dition until  the  operation  is  ended. 

Exceptions  to  this  rule  will  be  made  by  the  director  alone,  and 
then  only  when  anesthesia  would  defeat  the  object  of  the  experi- 
ment. In  such  cases  an  anesthetic  shall  be  used  so  far  as  possible 
and  may  be  discontinued  only  so  long  as  is  absolutely  essential  for 
the  necessary  observations. 

5.  At  the  conclusion  of  the  experiment  the  animal  shall  be 
killed  painlessly.  Exceptions  to  this  rule  will  be  made  only  when 
continuance  of  the  animal's  life  is  necessary  to  determine  the 
result  of  the  experiment.  In  that  case,  the  same  aseptic  precau- 
tions shall  be  observed  during  the  operation,  and  so  far  as  possible 
the  same  care  shall  be  taken  to  minimize  discomforts  during  the 
convalescence  as  in  a  hospital  for  human  beings. 

[Signed]    

Director  of  the  Laboratory. 


AND  MEDICAL  PROGRESS  247 

I  may  add  that  at  the  Rockefeller  Institute  regular 
trained  nurses  are  employed  and  are  on  duty  not  only 
during  the  day,  but  at  night  when  necessary. 

Self-confessed  total  ignorance  of  a  subject  on  which 
one  gives  extensive  evidence  is  not  often  known,  but 
Dr.  Herbert  Snow,  of  London,  an  authority  among  the 
antivivisectionists,  is  a  case  in  point.  Dr.  Snow's  evidence 
before  the  Royal  Commission  on  Vivisection  (1906)  covers 
ten  pages  quarto  and  he  answers  three  hundred  and  twenty- 
six  questions.  In  1911,  Dr.  Snow  visited  America.  In  a 
letter  to  the  Philadelphia  "  Ledger  "^  he  makes  the  almost 
incredible  statement  that  he  gave  all  this  evidence  "in 
utter  ignorance  of  the  vivisection  question." 

Moreover,  when  asked  by  the  Commission  (Question 
2242),  "Do  you  find  any  fault  with  the  present  gentlemen 
who  are  licensed  under  the  act"?  he  replied,  "I  do  not"; 
and  again  (Questions  2227  and  2228)  he  admits  that  both 
painful  and  painless  experiments  may  sometimes  be 
necessary. 

In  other  cases  ignorance  of  physiology  and  anatomy  is 
shown  which  would  only  excite  a  smile  did  it  not  gravely 
mislead  the  reader.  I  shall  give  only  a  single  illustration 
here.  Others  will  be  found  elsewhere  in  this  paper. 

"The  Nine  Circles,"  with  its  sulphurous  subtitle,  "Hell 
of  the  Innocent,"  is  an  English  book  originally  issued  by 
the  late  Miss  Frances  Power  Cobbe,  in  1892.  This  edition 
had  to  be  withdrawn  on  account  of  its  false  statements, 
especially  as  to  the  non-use  of  ether.^  A  second  and  revised 
edition  was  issued  in  1893.  This  was  "carefully  revised  and 
enlarged  by  a  subcommittee  especially  appointed  for  the 
purpose,"  as  the  preface  states. 

On  page  15  of  the  revised  edition,  it  is  correctly  stated 
that  Professor  Henry  P.  Bowditch,  of  the  Harvard 
Medical  School,  in  some  experiments  on  the  circulation, 
etherized  a  cat  and  that  "then  its  sciatic  nerve  was 

1  Philadelphia  Ledger,  March  6,  1911.        «  See  'post,  pp.  265,  266. 


348  ANIMAL  EXPERIMENTATION 

divided,"  etc.  The  sciatic  nerve  is  the  largest  nerve  in 
the  body  of  man  and  animals  and  passes  down  the  back 
of  the  leg.  After  division  of  the  nerve  the  portion  going 
down  the  leg  below  the  place  where  the  nerve  was  divided 
was  stimulated  by  an  electrical  current.  As  this  part  of 
the  nerve  was  wholly  cut  off  from  the  spinal  cord  and 
brain,  by  no  possibility  could  any  pain  be  felt.  Yet  a  Boston 
lawyer,  in  a  leaflet  published  by  the  New  England  Anti- 
vivisection  Society,  comments  on  a  similar  experiment  as 
follows:  "It  will  be  readily  seen  even  by  the  casual  reader 
that  it  involves  an  amount  of  agony  beyond  which  science 
is  unable  to  go."  Just  how  the  "casual  reader"  would  be 
so  well  informed  as  to  physiology  when  a  lawyer  and  two 
doctors  —  not  casual  but  intelligent  and  careful  readers 
—  got  things  totally  wrong,  is  not  stated.  Dr.  Bowditch 
published  a  correction  ^  of  this  misstatement  in  1896.  In 
spite  of  this,  the  New  England  Antivivisection  Society  in 
1909,  thirteen  years  after  this  public  correction,  was  still 
distributing  this  lawyer's  statement. 

But  in  "The  Nine  Circles"  (second  edition,  carefully 
revised  by  Dr.  Berdoe  and  the  committee)  these  experi- 
ments are  referred  to  as  "experiments  on  the  spinal  cord*'\ 
(Italics  mine.)  Yet  Bowditch  did  no  operation  on  the  spinal 
cord.  Miss  Cobbe,  not  being  an  anatomist,  might  be  par- 
doned for  confusing  the  thigh  and  the  spine  of  the  cat, 
but  surely  Dr.  Berdoe  ought  to  have  seen  to  it  that 
"sciatic  nerve"  and  "spinal  cord"  were  not  used  as  inter- 
changeable terms. 

Many  years  ago,  after  amputating  a  leg  near  the  hip, 
I  tried  to  see  now  long  electric  stimulation  of  the  sciatic 
nerve  would  cause  the  muscles  of  the  amputated  leg  to 
contract.  After  four  hours,  during  all  of  which  time 
the  muscles  continued  to  react,  I  had  to  stop  as  I  could 
give  no  more  time  to  the  experiment.  According  to  the 
canons  of  antivivisection  as  voiced  above,  I  should  have 

*  Henry  P.  Bowditch,  Advancement  of  Medicine  by  Research,  p.  43. 


AND  MEDICAL  PROGRESS  249 

continued  to  etherize  the  patient  whose  leg  had  been 
amputated,  for  he,  just  as  much  as  Bowditch's  cat,  could 
feel  "agony  beyond  which  science  is  unable  to  go." 

Let  me  give  only  two  other  surprising  statements. 
Dr.  Hadwen^  criticizes  my  reference  in  "Harper's  Mag- 
azine "^  to  "an  astringent  named  *  adrenalin.'"  I  had 
shown  how  valuable  adrenalin  had  been  in  saving  human 
life  in  certain  surgical  conditions,  and  also  described  the 
resuscitation,  by  means  of  adrenalin  and  salt  solution, 
of  a  dog  which  had  been  "dead"  for  fifteen  minutes.  Dr. 
Hadwen  concludes  his  paragraph  thus:  "But  it  does 
seem  a  pity  that  these  New  World  vivisectors  will  not  be 
able  to  perform  the  resurrection  miracle  without  first 
killing  somebody  to  get  at  his  kidneys."  The  presumable 
object  of  "getting  at  his  kidneys"  would  be  in  order  to 
make  adrenalin  from  them.  Now  adrenalin  is  not  made 
from  the  kidneys  at  all,  least  of  all  from  human  kidneys, 
but  from  the  adrenal  glands  of  animals. 

In  the  same  article  he  vaunts  the  use  of  salt  solution 
instead  of  the  direct  transfusion  of  blood,  and  rightly 
says  that  he  has  "seen  the  most  marvelous  effects  follow 
the  injection  of  an  ordinary  saline  solution  into  the  venous 
system  in  cases  of  loss  of  blood."  But  he  seems  to  be 
ignorant  of  the  fact  that  this  very  saline  transfusion  was 
begun  and  perfected  by  experiments  on  animals.  I  com- 
mend to  him  Schwarz's  essay  (Halle,  1881)  with  its  twenty- 
four  experiments  on  rabbits  and  dogs,  and  Eberius's  essay 
(Halle,  1883)  with  its  ten  experiments  on  rabbits  and  the 
record  of  eleven  cases  in  which  Schwarz*s  method  had 
already  been  used  in  man.  These  essays  were  practically 
the  beginning  of  our  knowledge  of  the  advantages  of  the 
use  of  salt  solution  over  the  old  dangerous  methods  of 
transfusion  of  blood. 

*  Hadwen,  Jour,  of  Zoophily,  January,  1910. 

2  W.  W.  Keen,  "Recent  Surgical  Progress,"  Harper's  Magazine^  April, 
1909;  reprinted  in  this  volume,  ante,  p.  151. 


«50  ANIMAL  EXPERIMENTATION 

The  antivivisectionists  deny  the  truths  of  bacteriology. 
Yet  we  practical  physicians,  surgeons,  and  obstetricians 
know  by  daily  experience  that  Pasteur's  and  Lister's  re- 
searches are  the  basis  of  most  of  our  modern  progress. 
Are  Hadwen,  Harrigan,  Snow,  and  their  colleagues  right, 
and  have  all  medical  colleges  all  over  the  world,  in  estab- 
lishing chairs  of  bacteriology,  and  all  medical  men,  in 
believing  bacteriologic  diagnosis  of  such  importance  and 
in  basing  on  the  germ  theory  their  antiseptic  treatment, 
which  has  so  revolutionized  modern  surgery,  been  wholly 
wrong?  The  germ  theory  is  as  well  established  as  the 
doctrine  of  the  circulation  of  the  blood. ^ 

//.  Fostering  a  Spirit  of  Cruelty  to  Human  Beings 

My  second  reason  for  believing  that  antivivisection 
injures  character  is  that,  by  putting  a  greater  value  on 
the  well-being  and  the  lives  of  monkeys,  guinea-pigs, 

*  In  Mrs.  White's  answer  to  this  address  (Boston  Med.  and  Surg.  Jovr., 
July  25,  1912,  p.  143),  as  the  editor  on  p.  131  points  out,  her  reference  to 
the  "fever  inseparable  from  the  healing  of  abdominal  wounds"  shows  her 
ignorance  of  the  results  of  modern  progress  in  surgery.  Thanks  to  bac- 
teriology and  the  antiseptic  method  of  Lister  and  his  followers,  thousands 
of  surgeons  and  patients  the  world  over  can  confinn  my  own  experience, 
both  as  a  surgeon  and  as  a  patient,  that  no  fever  usually  follows  a  clean 
abdominal  operation.  Before  Lister's  day,  not  only  was  there  the  terrible 
fever  and  suflFering  of  peritonitis,  but  the  mortality  was  so  great  that  we 
never  dared  to  do  many  operations  which  are  now  commonplace  and 
rarely  fatal.  Another  illustration  of  ignorance  of  surgery  is  found  in  Mrs. 
White's  reference  (p.  143)  in  the  same  paragraph  to  the  "pain  caused  by 
the  presence  of  gall-stones  in  the  gall-bladder,"  a  pain  which  she  says  "is 
generally  considered  the  most  violent  pain  known."  Now,  it  is  true  that 
sometimes  "gall-stones  in  the  gall-bladder"  do  cause  some  or  even  consid- 
erable pain;  but  many  posi-mortem  examinations  reveal "  gall-stones  in  the 
gall-bladder"  which  have  never  given  the  patient  the  slightest  pain,  and 
the  patient,  therefore,  was  totally  ignorant  of  their  presence.  The  "vio- 
lent pain"  to  which  she  refers  is  not  due  to  their  presence  in  the  gall- 
bladder, but  to  the  terrible  "gall-stone  colic"  caused  by  the  passage  of  the 
gall-stones  out  of  the  gall-bladder  into  its  duct,  or  tube,  opening  into  the 
bowel.  Modern  antiseptic  surgery  prevents  these  constantly  recurring 
attacks  by  safely  removing  the  gall-stones  from  the  gall-bladder  or  from 
the  gall-duct. 


AND  MEDICAL  PROGRESS  251 

rabbits,  dogs,  cats,  mice,  and  frogs  than  on  the  Kves  of 
human  beings,  it  fosters  a  spirit  of  cruelty  to  human 
beings. 

Is  it  not  a  cruel  passion  which  will  lead  men  and  women 
to  write  such  letters  and  to  print  such  epithets  as  I  have 
quoted?  Is  it  a  right  thing  to  misstate  the  facts  of  opera- 
tions, and  after  the  falsity  of  the  charge  has  been  proved, 
still  continue  for  years  to  hold  up  men  with  human  f eehngs 
and  sensitive  to  abuse  before  the  community  as  vile  mon- 
sters of  cruelty?  Nay,  more  than  this,  is  it  not  an  extra- 
ordinary thing  that  those  who  so  vehemently  denounce 
human  vivisection  are  even  among  its  advocates? 

When  I  was  professor  of  surgery  in  the  Woman's 
Medical  College  of  Pennsylvania,  I  took  as  the  topic  of 
my  address  at  one  of  the  commencements,  "Our  Recent 
Debts  to  Vivisection."^  Mrs.  Caroline  Earle  White  pub- 
lished "An  Answer  to  Dr.  Keen's  Address  entitled,  *Our 
Recent  Debts  to  Vivisection. ' "  At  the  bottom  of  page  4 
I  find  the  following:  — 

I  take  issue  with  Dr.  Keen  in  the  second  place  where  he  says, 
"These  experiments  cannot,  nay,  must  not,  be  tested  first  upon 
man."  I  assert,  on  the  contrary,  that  in  the  majority  of  cases  they 
miLst  he  tested  first  upon  man  [italics  my  own]  or  not  tested  at  all, 
because  no  important  deductions  can  ever  be  drawn  with  any 
degree  of  certainty  from  experiments  upon  animals,  since  in  some 
inexplicable  way  their  construction  is  so  different  from  that  of 
man. 

The  statements  in  the  latter  portion  of  the  concluding 
sentence  will  much  amuse  anatomists,  physiologists,  and 
biologists,  or,  in  fact,  any  one  who  really  knows  anything 
about  science.  With  minor  modifications,  man  and  the 
lower  animals  are  alike  in  almost  all  particulars,  both  in 
structure  and  function,  in  health  and  disease. 

The  extraordinary  fact  is  that  Mrs.  White  asserts  that 
experiments  must  be  tested ^r 5^  on  men  or  not  tested  at  all. 
^  See  the  first  paper  in  this  volume. 


252  ANIMAL  EXPERIMENTATION 

That  is  to  say,  we  must  either  experiment  on  human 
beings  or  else  continue  in  exactly  the  same  old  rut  as  before 
and  never  make  any  progress,  for  every  departure  from 
prior  practice,  however  slight,  is  an  "experiment." 

If  this  basic  doctrine  of  antivivisection  had  held  good, 
for  the  last  fifty  years  Lister  would  not  have  been  able, 
after  carefully  testing  his  antiseptic  method  on  animals 
and  having  found  it  successful,  then,  and  not  before 
then,  to  try  it  on  man.^  By  this  means  he  became,  as  the 
"British  Medical  Journal"  has  just  called  him,  "the 
maker  of  modem  surgery." 

On  page  10  of  Mrs.  White's  "Answer"  is  found  the 
following  flat-footed  advocacy  of  human  vivisection :  — 

Dr.  Keen  mentions  that  in  India  alone  twenty  thousand  human 
beings  die  annually  from  snake  bites  and  as  yet  no  antidote  has 
been  discovered.  How  can  we  search  intelligently  for  an  antidote, 
he  says,  until  we  know  accurately  the  effects  of  the  poison?  I 
should  reply  that  in  order  to  find  out  the  effects  of  the  poison  and 
to  search  also  for  an  antidote,  the  best  plan  would  be  for  the  experi- 
menters to  go  to  India  where  they  could  find  as  large  a  field  for 
investigation  as  they  require  in  the  poor  victims  themselves. 
Here  is  an  opportunity  such  as  is  not  often  offered  for  experimenting 
upon  human  beings,^  since  as  they  would  invariably  die  from  the 

^  W.  W.  Keen,  "Modern  Antiseptic  Surgery  and  the  R6Ie  of  Experi- 
ment in  its  Discovery  and  Development,"  Jour.  Am.  Med.  Assn.,  April  2, 
1910,  p.  1104.  Reprinted  in  the  series  of  pamphlets  on  Defense  of  Re- 
search (see  p.  xix),  and  in  the  present  volume,  ante,  p.  199. 

2  In  her  answer  to  this  address  (Boston  Med.  and  Surg.  Jour.,  July  25, 
1912,  p.  143),  Mrs.  White,  after  twenty-seven  years  for  reflection,  de- 
fends her  proposal  for  "  experimenting  on  human  beings,"  saying  that 
"it  does  not  seem  to  me  that  this  is  a  cruel  suggestion,  as  my  only  object 
in  it  was  to  benefit  the  poor  natives  who  die  by  the  thousand  every 
year."  Such  a  defense  places  her  clearly  and  definitely  among  the  ad- 
vocates of  vivisection,  whose  only  "object"  is  to  prevent  death  "by 
thousands  every  year."  This  object,  moreover,  has  already  been  obtained 
in  a  score  of  diseases  and  will  be  obtained  hereafter  in  many  others,  not, 
however,  by  "experimenting  on  human  beings,"  as  she  advocates,  but 
on  dogs,  cats,  rabbits,  guinea-pigs,  mice,  frogs,  etc. 

And  now  the  associate  editor  of  the  Journal  of  ZoophUy,  in  the  last  issue 
of  her  journal  I  have  received  (July,  1914,  p.  101),  horribile  dictu,  enters  her 
plea  for  vivisection!   She  holds  with  her  London  hero.  Dr.  Snow,  that 


AND  MEDICAL  PROGRESS  253 

snake  bites,  there  can  be  no  objection  to  trying  upon  them  every 
variety  of  antidote  that  can  be  discovered.  Nothing  seems  to  me  less 
defensible  than  these  experiments  on  the  poison  of  snake  bites 
upon  animals  since  it  is  the  one  case  in  which  they  could  be 
observed  with  so  much  satisfaction  and  certainty  upon  man! 
[Italics  my  own.] 

Such  a  proposal  is  as  absurd  as  it  is  cruel.  Even  if  the 
experimenter  could  afford  sufficient  time  and  money  to 
go  to  India  for  months  or  rather  for  years,  how  could  he 
arrange  to  be  present  when  such  unexpected  accidents 
occurred?  How  could  he  have  at  hand  in  the  jungle  the 
ether,  chemicals,  assistants,  tables,  tents,  food  and  drink, 
and  the  necessary  yet  intricate  and  delicate  instruments? 
And  even  if  he  had  all  of  these,  how  could  he  work  with  the 
calmness  and  the  orderly  deliberation  of  the  laboratory 
when  a  fellow  human  being's  life  was  ebbing  away  and 
every  minute  counted  in  such  a  swift  poison?  The  proposal 
is  cruel  and  revolting  and  would  never  be  accepted  by  any 
investigator. 

But  Mrs.  White  is  not  the  only  one  who  is  guilty  of 
making  such  a  proposal.  Many  antivivisection  leaflets 
and  pamphlets  express  the  wish  that  the  vivisectors 
should  be  vivisected.  In  a  pamphlet^  freely  distributed 
in  the  United  States  I  find  the  following  in  a  letter  from 
a  man  who  was  at  that  time  a  Senator  of  the  United 
States : — 

It  would  be  much  better  to  dissect  men  alive  occasionally 
for  the  general  welfare  because  the  attendant  phenomena  and 
demonstration  of  the  victims  being  of  our  own  particular  form 
of  animal  would  be  far  more  valuable  than  the  result  of  our 
observation  upon  the  physical  structure  illustrated  in  the  ago- 
nies unto  death  of  the  helpless  creatures  around  us. 

*' research  among  the  lower  organisms  is  the  main  path  to  be  followed  in  the 
ages  yet  to  be."  True  it  is  claimed  that  "it  would  not  inflict  a  pang  on 
any  sentient  creature."  Yet  it  is  also  asserted  that  the  health  of  these 
lower  organisms  "primarily  depends  on  the  condition  of  its  [their]  nerves.  '* 
Pray  what  are  nerves  for? 

^  Frances  Power  Cobbe,  and  Benjamin  Bryan,  Vivisection  in  America, 
p.  15. 


254  ANIMAL  EXPERIMENTATION 

The  English  is  as  distressing  as  the  proposal  is  astounding. 

Let  me  give  one  more  illustration  of  the  effect  of  anti- 
vivisection  in  encouraging  cruelty. 

To-day  the  plague,  cholera,  and  yellow  fever  no  longer 
terrify  Europe  or  America.  What  is  the  reason  for  this? 
Primarily  and  chiefly  the  discovery  of  the  germs  of  cholera 
and  of  the  plague  by  bacteriologic  methods,  which  in  turn 
are  very  largely  the  result  of  experiment  on  animals,  and 
of  the  means  of  the  transmission  of  yellow  fever,  though 
as  yet  not  of  its  cause.  In  the  latter  case  experiments  on 
animals  were  out  of  the  question  because  it  is  impossible 
to  transmit  yellow  fever  to  animals.  They  are  not  suscepti- 
ble to  the  poison.  So  a  number  of  noble  medical  men  and 
others  volunteered  to  have  experiments  tried  on  them.  The 
very  first  experiments  were  tried  on  medical  men.  These 
men  slept  in  a  stifling  atmosphere  for  twenty  nights  in  the 
beds  in  which  yellow  fever  patients  had  died,  and  in  their 
very  clothes,  —  clothes  soiled  with  their  black  vomit,  urine 
and  feces;  tried  to  inoculate  themselves  by  putting  some 
of  the  black  vomit  into  their  eyes,  or  by  hypodermic  injec- 
tions, etc.,  but  all  in  vain.  By  none  of  these  methods  were 
they  able  to  inoculate  themselves  with  the  fever.  One  step 
more  was  requisite  —  to  learn  whether  a  well  man  bitten 
by  an  infected  mosquito,  but  having  been  exposed  to  no 
other  possible  source  of  infection,  would  contract  the 
disease.  Dr.  Carroll,  of  the  army,  was  the  first  to  offer 
himself,  and  nearly  lost  his  life.  Others  followed.  Several 
lost  their  lives,  among  them  Dr.  Lazear,  at  the  beginning 
of  a  most  promising  career.^ 

Contrast  with  this  a  cruel  letter  ^  written  by  a  woman : 

Science  is  based  on  such  firm  foundation,  indeed,  that  it 
can  at  a  moment's  notice  be  tumbled  down  and  become  a 
wrecked  mass  by  a  mosquito!  Not  only  this,  but  these  lifelong 
vivisectors  could  not  even  prolong  their  own  lives.  Undone  by  a 
mosquito!  I  shall  always  have  unbounded  admiration  for  thai 
clever  insect.  [Italics  mine.] 

1  See  ante  p.  229.  2  jsjew  York  Herald,  August  2,  1909. 


AND  MEDICAL  PROGRESS  255 

This  self-sacrijSce  for  humanity  has  made  us  masters 
the  world  over  of  yellow  fever,  has  made  possible  the 
Panama  Canal,  has  saved  many  thousands  of  human  lives 
and  millions  of  dollars  in  our  own  Southern  States  alone, 
and  yet  a  woman  can  feel  "unbounded  admiration  for  the 
clever  insect"  which  slew  these  heroes  and  had  devastated 
cities  and  countries  for  centuries !  Does  not  such  anti vivi- 
section zeal  "hurt  character"? 

Two  men  are  especially  obnoxious  to  the  antivivisec- 
tionist:  Pasteur,  whose  demonstration  of  the  cause  of  that 
form  of  infection  known  as  puerperal  or  childbed  fever 
alone  would  have  made  his  name  immortal;  and  Lister, 
whose  application  and  extension  of  the  principles  laid 
down  by  Pasteur  have  revolutionized  all  modern  surgery. 

I  need  not  argue  the  case  for  Pasteur,  Lister,  and  mod- 
ern antiseptic  surgery.  Excepting  the  antivivisectionists, 
every  intelligent  man  and  woman  the  world  over  knows 
that  modem  surgery  has  been  made  safe  by  their  researches. 
Let  me  give  a  single  instance. 

In  the  charming  "Life  of  Pasteur"  by  Rene  Vallery- 
Radot,  it  is  stated^  that,  hoping  to  overcome  the  almost 
invariably  fatal  results  of  ovariotomy  in  the  hospitals, 
the  authorities  of  Paris  "hired  an  isolated  house  in  the 
Avenue  de  Meudon,  a  salubrious  spot  near  Paris.  In  1863 
ten  women  in  succession  were  sent  to  that  house.  The 
neighbors  watched  those  ten  patients  entering  the  house, 
and  a  short  time  afterward  their  ten  coflBns  being  taken 
away!" 

To-day,  thanks  to  Pasteur  and  Lister  and  modern  sur- 
gery, based  on  experiment  on  animals  more  than  on  any 
other  foundation,  not  more  than  two  or  three  in  a  hundred 
die  after  ovariotomy.  Yet,  if  the  antivivisectionists  had 
prevailed,  the  horrible  mortality  of  the  earlier  days  and 
even  the  tragedy  of  the  ten  women  and  the  ten  coffins 
would  still  exist.  Is  not  this  cruelty? 

^  Vallery-Radot,  Life  of  Pasteur,  vol.  ii,  p.  16. 


256  ANIMAL  EXPERIMENTATION 

Let  me  take  another  illustration  of  a  similar  cruelty, 
a  form  especially  interesting  to  women.  Professor  J. 
Whitridge  Williams,  ^  professor  of  obstetrics  in  the  Johns 
Hopkins  University,  states  the  following  facts:  In  1866 
Lefort  showed  that  in  888,312  obstetric  cases  in  the 
hospitals  of  France  up  to  1864,  30,394  women  had  died  of 
puerperal  fever;  that  is  to  say,  3.5  per  cent,  or  about  every 
twenty-seventh  mother.  From  1860  to  1864  the  mortality 
in  the  Maternite  of  Paris  had  risen  nearly  fourfold,  to  12.4 
per  cent.  In  December,  1864,  it  rose  to  57  per  cent;  that  is 
to  say,  more  than  one  half  of  the  women  who  bore  children 
in  that  hospital  in  that  month  died  of  childbed  fever! 
In  Prussia  alone,  in  the  sixty  years  from  1815  to  1875, 
Boehr  showed  that  363,624  women  had  died  of  the  same 
fever  and  estimated  that  every  thirtieth  prospective  mother 
was  doomed  to  death  from  that  cause.  In  the  United 
States,  Hodge,  of  Philadelphia,  showed  that  in  the  Penn- 
sylvania Hospital,  from  1803  to  1833,  there  had  been  a 
mortality  of  5.6  per  cent;  i.e.,  every  eighteenth  mother 
was  doomed.  Lusk  reported  an  epidemic  in  1872  with  18 
per  cent;  that  is,  almost  every  fifth  mother  perished  from 
the  same  fever! 

As  late  as  March,  1879,  only  thirty-three  years  ago,  at 
the  Paris  Academy  of  Medicine,  when  the  leading  men  in  a 
debate  on  childbed  fever  were  at  a  loss  to  account  for  it, 
Pasteur  drew  on  the  blackboard  what  we  now  know  as  the 
streptococcus  and  declared  this  little  vegetable  organism 
to  be  its  cause.  Our  own  Oliver  Wendell  Holmes,  in  1843, 
was  the  first  who  declared  on  clinical  grounds  that  the 
doctors  and  the  nurses  carried  the  contamination,  but  how 
and  why  he  could  not  know,  for  bacteriology  did  not  then 
exist.  He  was  followed  by  Semmelweis,  of  Vienna,  who, 
in  1861,  still  further  reinforced  the  reasoning  of  Holmes, 

*  J.  Whitridge  Williams,  "Obstetrics  and  Animal  Experimentation," 
Jour.  Am.  Med.  Assn.,  April  22, 1911,  p.  1159,  and  no.  xviii  in  the  series  of 
pamphlets  on  Defense  of  Research.    (See  p.  xix.) 


AND  MEDICAL  PROGRESS  257 

and  for  his  pains  was  tabooed  by  his  professional  colleagues 
and  ended  his  life  in  a  madhouse. 

The  result  of  Pasteur's  researches  and  the  practical 
application  of  Lister's  antiseptic  method  to  obstetrics  as 
well  as  to  surgery  have  borne  the  most  astounding  and 
gratifying  fruit.  For  instance,  in  1909,  Markoe  reported 
in  the  New  York  Lying-in  Hospital  in  60,000  births  a 
maternal  mortality  of  only  0.34  per  cent,  and  Pinard,  in 
1909,  in  45,633  births  recorded  a  mortality  of  only  0.15  per 
cent,  while  in  1907  Hermann  had  been  able  to  report  a 
mortality  of  only  0.08  per  cent  in  8700  patients!  In  other 
words,  these  reports  show  in  round  numbers  that,  taking 
in  the  two  extremes,  the  deaths  from  childbed  fever  fell 
from  the  extraordinary  rate  of  fifty-seven  in  a  hundred 
mothers,  or  the  former  usual  rate  of  five  or  six  in  every 
hundred  mothers,  to  one  mother  in  1250. 

If  for  fifty  years  past  the  antivivisectionists  had  had 
their  way,  all  these  marvelous  results  in  obstetrics  would 
have  been  prevented  and  women  would  still  be  dying  by 
the  hundred  and  the  thousand  from  puerperal  fever  —  an 
entirely  preventable  disease.  Would  it  not  have  been  the 
height  of  cruelty  to  stop  these  experiments?  But  according 
to  the  "Journal  of  Zoophily"  such  wonderful  life-saving 
experiments  should  be  prohibited,  ^'no  matter  how  great  the 
anticipated  benefit*' 

In  surgery,  erysipelas,  blood  poisoning,  lockjaw,  hospital 
gangrene,  etc.,  would  still  be  killing  our  patients  right  and 
left;  weeks  of  suffering,  to  say  nothing  of  danger,  would 
confront  every  patient  operated  on;  the  modem  surgery 
of  the  head,  of  every  organ  in  the  abdomen  and  pelvis,  of 
tumors  and  of  cancer,  amputations  and  many  other  opera- 
tions, instead  of  being  almost  painless  and  so  safe  as  they 
are  to-day,  would  be  the  cause  of  prolonged  illness,  pain 
and  death;  in  fact,  most  of  them  would  be  deemed  entirely 
impossible  of  performance  —  they  were  impossible  before 
Pasteur  and  Lister  —  and  animals  themselves  would  still 


258  ANIMAL  EXPERIMENTATION 

be  suffering  as  of  old  from  animal  maladies  whose  causes 
are  now  known  and  whose  ravages  have  been  enormously- 
diminished. 

Call  you  not  the  desire  to  arrest  such  experiments 
cruelty  to  man  and  animals  alike? 

In  a  speech  in  the  House  of  Commons,  April  4,  1883, 
Sir  Lyon  Play  fair,  the  Deputy  Speaker,  said:  — 

For  myself,  though  formerly  a  professor  of  chemistry  in  the 
greatest  medical  school  of  this  country  [Edinburgh],  I  am  respon- 
sible only  for  the  death  of  two  rabbits  by  poison,  and  I  ask  the 
attention  of  the  House  to  the  case  as  a  strong  justification  for 
experiments  on  animals;  and  yet  I  should  have  been  treated  as  a 
criminal  under  the  present  act  [the  British  vivisection  law]  had  it 
then  existed. 

Sir  James  Simpson,  who  introduced  chloroform,  .  .  .  was  then 
alive  and  in  constant  quest  of  new  anesthetics.  He  came  to  my 
laboratory  one  day  to  see  if  I  had  any  new  substances  likely  to  suit 
his  purpose.  I  showed  him  a  liquid  which  had  just  been  discov- 
ered by  one  of  my  assistants,  and  Sir  James,  who  was  bold  to 
rashness  in  experimenting  on  himself,  desired  immediately  to 
inhale  it  in  my  private  room.  I  refused  to  give  him  any  of  the 
liquid  unless  it  was  first  tried  on  rabbits.  Two  rabbits  were 
accordingly  made  to  inhale  it;  they  quickly  passed  into  anesthesia 
and  apparently  as  quickly  recovered,  but  from  an  after-action  of 
the  poison  they  both  died  a  few  hours  afterward.  Now  was  this 
not  a  justifiable  experiment  on  animals.'^  Was  not  the  sacrifice  of 
two  rabbits  worth  saving  the  life  of  the  most  distinguished  physi- 
cian of  his  time? 

As  this  experiment  was  not  for  the  good  of  the  two 
rabbits,  but  in  fact,  killed  them,  in  the  eye  of  present-day 
antivivisectionists  it  would  be  wrong,  and,  if  they  had 
their  way,  illegal  and  punishable,  and  Simpson  would  have 
lost  his  life.  Would  not  this  be  cruelty? 

Let  me  state  briefly  two  of  the  most  recent  discoveries 
in  medicine  and  surgery :  — 

1.  Vaccination  against  typhoid  fever.  Starting  from 
Pasteur's  researches  on  animal  diseases  and  continued 
by  various  observers,  and  especially  in  the  last  few  years 


AND  MEDICAL  PROGRESS  259 

by  Sir  Almroth  Wright,  of  London,  there  has  been  devel- 
oped, chiefly  by  experiments  on  animals,  a  "vaccine"  to 
'prevent  typhoid  fever.  When  by  such  experiments  the 
method  was  found  to  be  sufficiently  safe,  it  was  tried  on 
man. 

In  the  Boer  War,  and  among  the  German  troops  in 
their  African  colonies,  tentative  trials  of  its  value  were 
made.  Now  it  has  been  tried  in  the  United  States  Army 
on  a  larger  scale  and  with  more  astonishingly  good  results 
than  in  any  previous  trials. 

During  the  Spanish  War  there  were  20,738  cases  of 
typhoid  and  1580  deaths;  nearly  one  fifth  of  the  entire  army 
had  the  disease.  It  caused  over  86  per  cent  of  the  entire 
mortality  of  that  war!  In  some  regiments  as  many  as  400 
men  out  of  1300  fell  ill  with  it.  How  this  would  handi- 
cap an  army  in  the  field  —  to  say  nothing  of  deaths  —  is 
evident. 

Lately  in  our  army  on  the  Mexican  border,  for  months 
under  war  conditions,  except  as  to  actual  hostilities,  there 
has  not  been  a  single  soldier  ill  with  typhoid.  This  is  due 
partly  to  better  sanitation  (which  in  turn  is  due  largely 
to  bacteriology),  but  chiefly  by  reason  of  wholesale  anti- 
typhoid vaccination.  This  is  evident  from  the  fact  that 
during  the  year  June  30,  1908,  to  1909,  when  this  vaccina- 
tion was  purely  voluntary  and  the  army  was  not  in  the 
field,  proportionately  sixteen  times  as  many  unvaccinated 
soldiers  fell  ill  with  the  disease  as  compared  with  the 
vaccinated.  On  the  Mexican  border  there  has  been  only 
one  single  case  of  typhoid,  not  in  a  soldier,  but  a  teamster 
who  had  not  been  vaccinated.  So  evident  are  the  benefits 
of  this  preventive  inoculation  that  Dr.  Nefl,  the  director 
of  health  of  Philadelphia,  has  issued  a  circular  proposing 
its  municipal  use,  and  also  to  prevent  typhoid  in  our  sum- 
mer resorts.  In  many  large  hospitals  it  is  extensively  used 
to  protect  the  physicians  and  nurses  from  catching  the 
fever. 


860  ANIMAL  EXPERIMENTATION 

Would  it  not  have  been  cruel  to  prevent  such  life-saving 
experiments  ?i 

2.  In  surgery  let  me  instance  the  surgery  of  the  chest. 
This  has  been  the  region  in  which  progress  has  lagged 
far  behind  that  of  all  the  other  parts  of  the  body  till 
within  the  last  five  or  six  years.  The  reason  was  that 
the  moment  you  opened  the  chest  cavity  to  get  at  the 
heart,  the  lungs,  the  esophagus,  the  aorta  or  the  pleura, 
it  was  like  making  an  opening  in  the  side  of  a  bellows. 
The  air,  instead  of  being  drawn  in  and  forced  out  through 
the  nozzle  (corresponding  to  the  mouth  in  the  case  of  a 
patient),  passed  in  and  out  through  the  opening  in  the  side 


1  The  Reports  of  the  Surgeon-General  of  the  Army  for  1909  to  1912 
show  the  following  number  of  cases  and  deaths  from  typhoid  fever:  — 


Protective  vaccination  was    entirely  voluntary  but 
was  gradually  winning  its  way. 
September  SO,  1911,  it  was  enforced  universally  in 
the  Army. 


Not  a  single  case  in  the  United  States,  Hawaii,  Porto  Rico,  Panama, 
Alaska,  or  the  Philippines!  Meantime  the  army  had  increased  in  numbers 
from  about  69,000  to  over  83,000! 

The  conclusion  of  the  Surgeon-General  is  that,  as  a  result  of  the  pro- 
tection aflForded  by  the  anti-typhoid  "vaccination,"  "typhoid  fever  will 
cease  to  be  a  scourge  to  the  army  in  the  future." 

In  the  Brit.  Med.  Jour,  for  August  22,  1914,  p.  369,  is  an  "  Appeal  by 
the  War  OflSce  "  urging  typhoid  vaccination  of  the  British  soldiers  en- 
gaged in  the  present  European  war.  One  fact  is  most  impressive  and 
exactly  corresponds  to  the  experience  of  our  own  American  army. 
Though  this  protective  vaccination  is  still  only  voluntary  in  the  Eng- 
lish army,  "about  93  per  cent  of  the  British  garrison  of  India  have  been 
protected  by  inoculation,  and  typhoid  fever,  which  used  to  cost  us  from 
three  hundred  to  six  hundred  deaths  annually  was  last  year  responsible  for 
less  than  twenty  deaths." 

Doubtless  our  antivivisection  friends  will  object,  as  they  do  in  the  case 
of  diphtheria,  smallpox,  etc.,  to  the  introduction  of  such  a  "vile  poison." 
What  does  common  sense  reply? 

Since  writing  this  I  find  in  the  Open  Door  (a  New  York  antivivisection 
organ),  in  its  issue  for  March,  1914,  an  article  entitled  "Typhoid  Vaccine 
Fraud  again  punctured"!  If  we  could  find  a  similar  "fraud"  against 
scarlet  fever,  measles,  whooping-cough,  etc.,  what  a  blessing  to  humanity] 


Year              Caaea 

Deaths 

1909  17S 

1910  142 

1911  69 

1912  27 

1913  1st  6  mos.    0 

16 

10 

8 

4 

0 

AND  MEDICAL  PROGRESS  261 

of  the  bellows  or  the  chest.  If  only  one  side  of  the  chest 
was  opened,  breathing  was  embarrassed,  if  both  sides  were 
opened,  the  patient's  lungs  collapsed,  breathing  was  impos- 
sible, and  death  ensued. 

Sauerbruch,  then  of  Breslau,  first  devised  a  large  air- 
tight box  or  chamber  in  which  the  pressure  of  the  air  could 
be  increased  or  diminished  at  will.  The  body  of  the 
patient,  the  surgeons,  nurses,  and  instruments  were  all 
inside  the  box,  and  a  telephone  enabled  them  to  give  direc- 
tions to  those  outside,  especially  to  the  etherizer.  The 
head  of  the  patient  with  an  air-tight  collar  around  his  neck 
protruded  outside  of  the  chamber  where  the  etherizer  also 
was  placed.  In  such  a  chamber  the  chest  could  be  safely 
opened.  But  while  this  was  an  immense  improvement, 
such  a  chamber  is  clumsy,  not  easily  transportable,  and  is 
very  expensive.  The  method  has  done  good  service,  how- 
ever. It  has  been  improved  by  others  and  is  in  use  to-day 
by  many  surgeons. 

At  the  Rockefeller  Institute,  Meltzer  and  Auer,  by  a 
number  of  experiments  on  animals,  have  lately  developed 
a  new,  simple,  and  safe  method  of  anesthesia  with  ether 
which  is  revolutionizing  the  surgery  of  the  chest  and  to 
a  considerable  extent  may  even  displace  the  ordinary 
inhalation  method  of  anesthesia.  As  soon  as  the  patient 
has  been  etherized  in  the  ordinary  way,  a  rubber  tube  is 
inserted  into  the  windpipe  through  the  mouth.  By  a  foot 
bellows  ether-laden  air  is  pumped  into  the  lungs  through 
this  tube,  the  foul  breath  escaping  between  the  tube  and 
the  windpipe  and  out  through  the  mouth.  Experiments 
on  animals  showed  that  the  rubber  tube  used  for  so  long  a 
time  would  not  injure  the  vocal  chords  and  so  alter  or 
destroy  the  voice  of  a  patient,  or  cause  injury  to  the  limgs, 
and  that  the  method  was  most  efficacious  in  the  surgery  of 
the  chest. 

I  saw  Carrel  thus  keep  a  dog  under  ether  for  about  an 
hour  and  a  half;  open  both  sides  of  the  chest  by  one  wide 


262  ANIMAL  EXPERIMENTATION 

sweep  of  the  knife;  displace  the  heart  and  lungs  this  way 
or  that;  expose  and  divide  the  aorta  between  two  clamps 
(the  clamps  were  applied  in  order  to  prevent  immediate 
fatal  hemorrhage) ;  do  a  tedious  and  difficult  operation  on 
the  aorta;  unite  its  two  cut  ends;  replace  the  heart  and 
lungs,  and  close  the  wound.  An  hour  later  the  dog,  which 
showed  no  evidences  of  suffering,  was  breathing  naturally, 
and  in  time  recovered  entirely. ^  What  this  method  means 
in  injuries  and  diseases  of  the  heart,  in  gangrene,  abscess 
and  tumors  of  the  lungs,  in  cancer  of  the  esophagus,  and 
foreign  bodies  lodged  in  the  esophagus  or  in  the  bronchial 
tubes,  and  in  diseases  of  the  aorta,  one  can  hardly  yet  even 
imagine. 

These  experiments  have  done  more  for  the  surgery  of 
the  chest  in  three  or  four  years  than  all  the  "cUnical 
observation"  of  cases  in  a  thousand  years.  The  method 
has  already  been  tried  successfully  in  several  hundreds 
of  cases  in  man,  and  the  future  has  in  store  for  us  a  new  and 
most  beneficent  chapter  in  the  surgery  of  the  chest. 

Yet,  if  the  antivivisectionists  had  prevailed,  all  these 
experiments  would  have  been  prevented,  the  doors  of  the 
Rockefeller  Institute  nailed  up,  and  men,  women,  and 
children  have  been  deprived  of  the  benefits  of  these  splen- 
did discoveries.  Call  you  not  that  intensely  cruel? 

Moreover,  these  very  same  people,  in  their  own  house- 
holds and  without  the  slightest  pity,  will  kill  rats  and  mice 
by  turning  them  over  to  the  tender  mercies  of  cats,  by 
drowning  them,  by  strangling  them  in  traps,  by  poisoning 
them  with  strychnin  or  phosphorus,  or  by  any  other  means 
of  "torture";  but  they  hold  up  their  hands  in  holy  horror 
when  any  proposal  is  made  to  terminate  the  lives  of  other 
rats  and  mice  almost  always  without  pain  and  with  im- 
mense benefit  to  humanity.  They  are  cruel  and  callous  to 

1  For  these  and  other  experimental  researches  Carrel  has  just  been 
awarded  the  Nobel  Prize  in  medicine  —  a  splendid  testimony  to  his  genius 
from  the  first  scientists  of  the  world. 


AND  MEDICAL  PROGRESS  263 

human  suffering  so  long  as  dogs  and  cats,  mice  and  guinea- 
pigs  escape!  And  yet,  as  I  have  shown,  only  twenty-six 
animals  in  a  thousand  can  possibly  ever  suffer  at  alll 

That  sentiment  rather  than  principle  is  at  the  bottom 
of  the  antivivisection  crusade  is  shown  by  what  I  in 
common  with  many  others  beheve  to  be  true,  that  if 
experimental  research  could  be  carried  on  on  other  animals 
without  using  dogs  and  cats  there  would  scarcely  have  been 
any  antivivisection  movement. 

///.  Lessened  Reverence  Jor  Truthfulness 

The  third  way  in  which  the  influence  of  antivivisection 
injures  character  is  by  diminishing  the  reverence  for 
truthfulness.  In  1901  I  gave  many  instances^  of  the  mis- 
statements of  the  antivivisectionists.  These  misstatements 
were  contained  in  two  anonymous  pamphlets,  and  I  have 
two  more  similar  pubHcations  which  are  also  anonymous. 
I  have  before  me  also  three  publications  purporting  to  be 
replies  to  that  publication  of  mine,  all  again  anonymous. 
Is  a  foe  who  attacks  from  ambush  worthy  of  the  respect 
and  confidence  of  the  public? 

These  misstatements,  so  far  as  I  know,  are  stiU  dis- 
tributed in  leaflets  and  pamphlets  without  correction 
nearly  eleven  years  after  their  incorrectness  was  shown. 
In  fact,  several  of  them  reappear  uncorrected  in  the 
"Journal  of  Zoophily"  for  July,  1911. 

Let  me  give  a  few  new  instances. 

The  most  prominent  antivivisectionist  in  England  is 
Mr.  Stephen  Coleridge.  On  page  183  (April  to  July,  1907), 
in  the  minutes  of  his  evidence  before  the  Royal  Commis- 
sion on  Vivisection,  I  find  the  following:  — 

Question  10952:  We  may  have  inspection,  but  still  we  may 
ask  a  person  of  character  when  he  saw  the  experiment  what  his 
opinion  of  it  was.  Will  you  not  accept  that? 

^  W.  W.  Keen,  "Misstatements  of  Antivivisectionists,"  Jour.  Am. 
Med.  Assn.,  February  23  and  August  10, 1901,  andante,  pp.  110  and  135 
of  this  volume. 


£64  ANIMAL  EXPERIMENTATION 

Answer:  Certainly  not,  because  I  think  that  all  these  experi- 
menters have  the  greatest  contempt  for  the  Act  of  Parliament. 
They  would  deny  a  breach  of  this  act  just  as  I  should  deny  a 
breach  of  the  Motor-Car  Act.  I  drive  a  motor-car,  and  when  I  go 
beyond  the  speed  limit  and  the  policeman  asks  me,  I  say,  "A^o, 
/  am  not  going  beyond  the  speed  limit  ^  [italics  mine].  Nothing 
would  keep  me  from  going  beyond  the  speed  limit  except  the 
presence  of  a  policeman  in  the  car;  and  nothing  will  keep  the 
experimenter  within  the  four  corners  of  the  act  except  an  inspec- 
tor in  the  laboratory. 

Question  10953:  Surely,  if  you  were  asked  about  the  speed 
limit  and  gave  your  word  that  you  had  not  exceeded  it,  you 
would  not  expect  to  be  disbelieved.'* 

Answer:  No,  I  did  not  say  so.  I  said  last  year  that  of  course  I 
did,  and  I  exceed  it  every  time. 

Question  10954:  You  are  apparently  not  very  ethical  about 
motor-cars  [italics  mine].  If  you  apply  your  principles  as  regards 
motoring  to  the  physiologists,  you  have  very  little  to  say  against 
them? 

Answer :  "VSTiat  I  have  to  say  is  that  they  regard  the  Vivisec- 
tion Act  of  1876  with  the  same  contempt  that  I  regard  the 
Motor-Car  Act  as  regards  the  speed  limit. 

In  quoting  also  a  letter  from  the  Home  OflSce,  Mr. 
Coleridge  admits  mutilating  it,  for  in  reply  to  Question 
11015,  he  says,  "I  seem  to  have  left  out  the  important  item 
of  it."  See  also  Questions  10301,  11011,  11024  and  19967 
to  19973. 

Comment  on  Mr.  Coleridge's  testimony  is  superJSuous. 

Again  in  the  "Black  Art  of  Vivisection,"  Mr.  Coleridge 

1  In  a  letter  referring  to  this  address  (Boston  Med.  and  Surg.  Jour., 
July  11,  1912,  p.  71),  Mr.  Coleridge  says  that  I  seem  "quite  shocked  that 
he  should  admit  that  he  constantly  breaks  the  law  and  exceeds  the  speed 
limit  of  twenty  miles  an  hour  in  his  motor-car,"  and  that  "a  quarter  of  a 
million  motorists"  do  the  same.  If  the  reader  will  again  peruse  Mr. 
Coleridge's  testimony,  as  quoted  in  the  text,  he  will  find  that  there  are 
two  admissions:  (1)  that  he  constantly  breaks  the  law,  i.e.,  the  "statute 
law,"  of  England  as  to  the  speed  limit;  and  (2)  that  when  he  goes  beyond 
the  speed  limit,  and  the  policeman  asks  him,  he  says,  "No,  I  am  not 
going  beyond  the  speed  limit.  The  last  statement  is  what  gives  special 
point  to  the  quotation  from  his  evidence,  but  in  his  letter  he  omits  any 
reference  to  this  more  important  admission  of  confessed  falsehood. 


AND  MEDICAL  PROGRESS  265 

states,  "The  Pasteur  institutes  in  Paris  and  elsewhere 
have  entirely  failed  to  prevent  people  dying  of  hydro- 
phobia." Yet  the  fact  is  that  formerly  from  twelve  to 
fourteen  per  cent  of  persons  bitten  developed  the  disease 
and  every  one  of  them  died,  whereas  the  result  of  the 
Pasteur  treatment  in  55,000  cases  has  diminished  the 
mortality  to  0.77  per  cent  of  those  bitten. 

I  cite  another  English  instance.  In  "The  Nine  Circles  "  * 
is  published  a  reply  to  a  letter  by  Sir  Victor  (then  Mr.) 
Horsley,  published  in  the  London  "Times,"  October  25, 
1892,  a  copy  of  which  I  have  before  me.  A  copy  of  the  now 
rare  first  edition  and  these  quotations  from  the  London 
"Times"  are  in  the  Library  of  the  College  of  Physicians 
of  Philadelphia.  The  book,  as  the  London  "Times"  points 
out  in  an  editorial,  was 

Compiled  under  his  [Dr.  Berdoe's]  direction.  He  was  en- 
trusted with  the  task  of  reading  the  proofs  and  was  supposed  to 
safeguard  the  accuracy  of  "the  compiler.'*  He  now  admits  that 
he  overlooked  in  Miss  Cobbe's  preface  a  passage  in  which  she 
"was  careful  to  say,  ...  so  far  as  it  has  been  possible,  the  use  or 
absence  of  anesthetics  has  been  noticed  in  regard  to  all  the 
experiments  cited  in  this  book.'*  Mr.  Horsley,  in  the  appendix 
to  his  letter,  which  we  publish  this  morning,  shows  by  reference 
to  some  twenty  cases  cited  in  "The  Nine  Circles'*  how  entirely 
inconsistent  with  the  truth  this  guarantee  is,  and  Dr.  Berdoe's 
reluctant  acknowledgment  completes  the  proof. 

A  still  more  remarkable  letter  appears  in  the  same 
number  of  the  "Times"  from  Professor  C.  S.  Sherrington, 
of  Liverpool.  He  says:  — 

I  find  in  the  book,  "The  Nine  Circles,*'  three  instances  in 
which  I  am  by  name  and  deed  held  up  to  public  abhorrence. 
From  each  of  the  three  statements  made  about  me  the  employ- 
ment of  anesthesia  in  my  experiments  is  studiously  omitted, 
although  expressly  mentioned  in  each  of  the  published  papers  on 
which  these  statements  are  professed  to  rest.  In  two  out  of 
three  statements  I  am  accredited  with  inflicting  on  living  ani- 

*  Second  edition,  pp.  23-28. 


266  ANIMAL  EXPERIMENTATION 

mals,  and  without  the  employment  of  anesthetics,  a  dissection 
and  procedure  that  I  'pursued  only  on  animals  which  were  dead. 

Accordingly,  the  society  withdrew  the  book  from  the 
market,  but  later  published  a  revised  second  edition. 

In  his  reply  to  Professor  Horsley's  letter  calling  atten- 
tion to  the  misstatements  in  the  first  edition,  the  excuses 
that  Dr.  Berdoe  gives  in  this  second  edition  are  very 
extraordinary.  Amoi^  them,  for  example,  one  is,  "The 
sentence  about  testing  the  sight  after  recovery  from  the 
anesthetic  was  overlooked."  Another  excuse  is,  "This  was 
taken  at  second  hand  from  another  report  where  the  ques- 
tion of  pain  was  not  under  discussion."  In  a  third  he  says, 
"We  have  not  always  access  to  *  original  papers'  and  can 
only  rely  on  such  reports  and  extracts  as  are  given  in  the 
medical  and  other  journals." 

I  ask  whether  it  is  fair,  square  dealing  to  base  grave 
charges  of  cruelty  on  sentences  "overlooked"  and  on 
"second-hand"  misinformation? 

But  Miss  Cobbe  was  by  no  means  satisfied  with  mis- 
representing English  medical  men.  In  the  pamphlet 
"Vivisection  in  America,"  I  find  on  page  9  a  letter  by  a 
Boston  lawyer  in  which  he  says  of  American  experiments : — 

In  other  words,  animals  are  dissected  alive,  usually  without 
the  use  of  anestheticsy  for  the  supposed  (but  illusory)  gain  to 
science  [italics  mine]. 

I  have  already  given  a  table  showing  that  only  twenty-six 
animals  out  of  a  thousand  could  by  any  possibility  have 
suffered  any  pain,  and  that  even  these  were  anesthetized. 
Is  it  correct,  then,  to  say  that  animals  are  "dissected  alive 
usually  without  anesthetics"? 

Near  the  top  of  page  45  Miss  Cobbe's  pamphlet  reads 
as  follows:  — 

Dr.  Ott,  in  the  "Journal  of  Physiology,'*  vol.  ii,  p.  42,  de- 
scribes a  number  of  experiments  on  a  number  of  cats  not  etherized 
[italics  my  own],  for  the  purpose  of  making  observations  on  the 
physiology  of  the  spinal  cord. 


AND  MEDICAL  PROGRESS  267 

I  find  that  on  reading  the  original  paper  there  were  four 
series  of  experiments:  — 

In  the  first  series,  there  were  twenty  experiments.  In 
the  first  experiment  the  animal  was  killed  before  the  experi- 
ment began.  In  eleven  other  instances  it  is  expressly- 
stated  in  each  experiment  that  the  animals  were  etherized. 
Dr.  Ott  informs  me  that  the  other  eight  were  so  etherized 
and  that  he  invariably  etherizes  the  animals. 

In  the  second  series  there  were  eight  experiments.  On 
page  52  of  the  "Journal  of  Physiology"  it  is  stated  that 
the  animals  were  etherized. 

The  third  series  consisted  of  ten  experiments,  and  on 
page  54  it  is  expressly  stated  that  the  animals  were 
etherized. 

The  fourth  series  consisted  of  ten  experiments  and  again 
on  page  60  it  is  stated  that  the  animals  were  etherized. 
We  see,  therefore,  that  Miss  Cobbe*s  statement  "not 
etherized"  is  untrue,  for  of  forty-eight  animals,  one  was 
killed  before  the  experiment  was  begun;  in  thirty-nine  it 
is  expressly  stated  that  they  were  etherized;  leaving  only 
eight  out  of  forty  as  to  the  etherization  of  which  nothing  is 
said,  though  it  was  done. 

On  pages  45  to  48  I  find  a  series  of  experiments  on  the 
surgery  of  the  pancreas  by  the  late  Dr.  Senn,  of  Chicago. 
This  was  in  July,  1886,  at  a  time  when  the  surgery  of  the 
pancreas  was  just  beginning.  Two  pages  and  a  half  of 
Miss  Cobbe's  pamphlet  are  devoted  to  describing  in  detail 
experiments  which,  as  no  mention  is  made  in  her  pamphlet 
of  ether,  one  would  certainly  suppose  were  done  without 
ether  and  would  surely  be  very  painful.  On  looking  at 
page  142  of  the  original  paper  I  find  that  it  is  expressly 
stated  that  the  animals  were  etherized. 

In  a  series  of  experiments  by  Halsted,  under  experiment 
No.  6,  p.  51,  Miss  Cobbe's  pamphlet  says,  "Died  under 
the  operation,  which  was  carried  on  for  two  hours  on  a 
young,  small  brindle  dog,"  which  would  imply  two  hours 


268  ANIMAL  EXPERIMENTATION 

of  **  agony."  The  original  expressly  states  the  fact  that  this 
dog  died  frcmi  the  effects  of  the  ether. 

So  much  for  Miss  Cobbe's  idea  of  reproducing  accurate 
accounts  of  the  experiments  to  which  she  refers. 

An  amusing  instance  of  misrepresentation  is  seen  in  an 
antivivisection  comment  made  on  one  of  Carrel's  experi- 
ments on  a  cat.  "How  intense  the  suffering  must  have 
been  to  cause  a  cat  (an  animal  usually  so  quiet  and  repose- 
ful) to  spend  the  day  jumping  on  and  off  the  furniture  1" 
As  a  matter  of  fact,  the  kitten  was  only  "playing  with  a 
ball  of  paper." 

Another  illustration  of  the  way  in  which  sentences  are 
detached  from  their  context  and  made  to  mean  quite 
different  things  and  repeatedly  published  years  after  the 
falsity  of  the  statement  has  been  demonstrated  is  shown  by 
the  constant  inclusion  of  Sir  Frederick  Treves  among  the 
opponents  of  vivisection.  He  stated  of  one  single  investiga- 
tion that  operations  on  the  intestines  of  dogs  in  his  opinion 
—  other  surgeons  do  not  hold  the  same  opinion  —  were 
useless  as  a  means  of  fitting  the  surgeon  for  operations  on 
the  human  bowel.  Ever  since  this  utterance^  Sir  Frederick 
Treves  has  been  constantly  quoted  in  the  manner  men- 
tioned, yet  in  a  letter  to  the  London  "Times"  of  April  18, 
1902,  he  says:  — 

The  fallacy  of  vivisection  can  hardly  be  said  to  be  established 
by  the  failure  of  a  series  of  operations  dealing  with  one  small 
branch  of  practical  surgery.  No  one  is  more  keenly  aware  than  I 
am  of  the  great  benefits  conferred  on  suffering  humanity  by  cer- 
tain researches  carried  out  by  means  of  vivisection. 

This  was  noticed  editorially  in  the  "British  Medical 
Journal"  of  April  26,  1902.  So  late  as  1909,  in  the  May 
number  of  the  "Journal  of  Zoophily,"  the  editor-in-chief, 
Mrs.  Caroline  Earle  White,  reprints  from  the  "North 
American"  of  April  12,  1909,  her  signed  letter,  and  implies 
*  Sir  Frederick  Treves,  Lancet^  London,  November  5,  1908. 


i 


AND  MEDICAL  PROGRESS  269 

that  Sir  Frederick  Treves  is  an  opponent  of  vivisection, 
seven  years  after  this  correction  had  appeared.  In  the 
number  of  the  same  journal  for  July,  1909,  the  associate 
editor  of  the  journal  prints  a  letter  of  denial  from  Sir 
Frederick  Treves,  and  yet  so  late  as  the  number  for  March, 
1911,  p.  177,  the  same  old  quotation  from  Sir  Frederick 
Treves  is  published  in  the  same  journal  which  twenty-two 
months  before  had  printed  his  own  letter  of  denial. ^ 

At  the  annual  meeting  of  the  Research  Defense  Society, 
Sir  Frederick  Treves,  in  referring  to  the  great  progress 
made  in  the  science  of  medicine,  said:  "This  progress  has 
in  the  main  been  accomplished  by  experiments  on  animals.'* 
Ought  not  his  name  hereafter  to  be  omitted  from  the  list 
of  the  opponents  of  vivisection? 

A  postal  card  issued  by  the  American  Antivivisection 
Society  in  Philadelphia  (there  are  several  others  of  the 
same  sort)  presents  a  picture  of  a  large  dog  with  his  mouth 
gagged  wide  open  and  his  paws  tied  "without  anesthetic." 
The  object  of  the  gag,  of  course,  is  to  prevent  the  animal 
from  biting  before  and  while  it  is  being  etherized.  It  is 
absurd  to  state  that  this  produces  any  pain,  but  a  guide 
at  the  traveling  antivivisection  exhibition  explained  to 
two  of  my  friends  that  it  was  used  to  break  the  jaws  of  the 
dogs!  and  that  this  was  done  "without  anesthetics."  But 
in  nearly  all  our  surgical  operations  within  the  mouth,  on 
the  tonsils,  cleft  palate,  the  tongue,  etc.,  we  employ  gags 
of  various  kinds  to  keep  the  mouth  wide  open.  To  show 
how  little  annoyance  this  causes,  here  is  a  picture  (Fig.  2) 
of  a  little  girl,  four  years  old,  my  own  granddaughter,  with 
a  mouth-gag  which  I  have  used  many  times  over  with 
children  and  adults  in  operations  about  the  mouth.  This 

1  Just  as  I  had  corrected  the  proof  of  this  paper,  April  29,  1912,  I 
received  through  the  mail  from  Mrs.  Caroline  Earle  White  a  reprint  of 
her  letter  of  April  12,  1909,  with  the  same  misleading  quotation,  thirty- 
three  months  after  Sir  Frederick  Treves's  letter  of  denial  had  been 
printed  in  her  own  journal. 

Sir  Frederick  Treves,  Brit.  Med.  Jour.,  July  8,  1911,  p.  82. 


270 


ANIMAL  EXPERIMENTATION 


particular  photograph,  it  will  be  observed,  was  taken  also 
"without  an  anesthetic."   It  was  not  necessary  to  tie  her 


Fig.  2.   Mouth-gag  as  used  in  operations  about  the  mouth. 

hands  and  feet  as  is  done  with  dogs,  for  the  child  regarded 
the  whole  proceeding  of  photographing  her  with  her  mouth 
wide  open  as  a  "lark,"  and  sat  as  still  as  a  mouse.  Is  it 
necessary  to  add  that  her  jaw  was  not  broken? 

Miss  Britton,  in  her  three-hundred-dollar  antivivisec- 
tion  prize  essay, ^  vividly  describes  an  operation  (removal 

1  Our  Dumb  Animals,  January,  1910. 


AND  MEDICAL  PROGRESS  271 

of  the  breasts  of  a  nursing  mother  dog)  which  was  never 
done  at  all.  This  fictitious  operation  is  described  in  "The 
Nine  Circles,"^  again  it  appears  in  Dr.  Albert  LeffingwelFs 
essay,  "Is  Science  Advanced  by  Deceit,"  published  in 
1900.  In  1901,  Professor  Bowditch  called  Dr.  Leffingwell's 
attention  to  the  fact  that  no  such  operation  was  ever  done. 
In  Dr.  LeflBngwelFs  collected  essays  entitled  "The  Vivisec- 
tion Question,"  on  page  169  of  the  second  revised  edition 
(1907),  there  is,  in  a  footnote,  a  correction  admitting  that 
no  such  operation  was  ever  done,  but  on  page  67  of  the 
same  edition,  a  description  of  this  same  operation  still 
appears  uncorrected,  six  years  after  Bowditch's  letter  had 
been  received  and  the  misstatement  acknowledged. 

In  the  Antivivisection  Exhibit  which  was  shown  in 
New  York,  in  the  winter  of  1909-10,  Professor  Lee  states 
that  there  was  "an  oven  heated  by  gas-burners  which 
contains  the  stuffed  body  of  a  rabbit  and  which  the  attend- 
ant tells  you  is  used  for  the  purpose  of  baking  live  animals 
to  death,  and  this  also  is  performed  without  anesthetics.'* 
Then  to  add  still  further  pathos,  the  note  at  the  end  of  the 
label  on  the  oven  said  "gagging,  muJffling,  or  severing  of 
vocal  organs  prevents  tortured  animals  giving  voice  aloud 
piteously  to  such  terrible  suffering."  As  a  matter  of  fact, 
"the  oven  is  an  apparatus  intended  for  the  incineration  of 
the  ,  ,  .  refuse  of  a  laboratory!**  I  might  add  that  it  is  a 
constant  practice  in  medicine  and  surgery  now  to  use  vari- 
ous forms  of  apparatus  for  the  purpose  of  "baking"  alive 
an  arm,  leg,  or  other  part  of  the  body,  and  lately  a  patient 
of  mine  has  had  her  arm  "baked"  almost  daily  for  weeks 
at  a  temperature  up  to  300  F.  with  great  benefit.^ 

In  the  exhibit  of  the  American  Antivivisection  Society 
in  Philadelphia  in  November,  1911,  a  portrait  of  a  dog 
was  shown  with  a  large  placard  stating  correctly  that  the 
dog  had  been  stolen  from  its  owner  and  sold  to  the  Univer- 
sity of  Pennsylvania  for  experiment.   It  omitted  to  state 

^  Second  edition,  p.  28.  2  ggg  ^jifg^  p.  g. 


272  ANIMAL  EXPERIMENTATION 

the  further  fact,  which  is  perfectly  well  known,  that  the 
dog  was  kept  for  identification  under  Rule  1  (page  245), 
was  claimed,  identified,  and  turned  over  to  its  owner  and 
not  used  for  experiment  Such  a  placard,  stating  half  the 
truth,  but  not  the  whole  truth,  inevitably  leads  the  pubHc 
to  draw  a  false  conclusion. 

The  bodies  of  three  dogs  were  also  exhibited,  each  la- 
beled, "The  Vivisected  Product  of  a  Philadelphia  Lab- 
oratory." All  show  gaping  wounds;  one,  in  fact,  has  the 
entire  abdomen  and  pelvis  wide  open.  Such  a  condi- 
tion is  utterly  incompatible  with  any  research.  Surgeons 
and  physiologists,  when  experimenting  on  animals,  are 
necessarily  as  scrupulously  careful  in  their  antiseptic 
technic  as  in  operations  on  human  beings.  Wounds  are 
accurately  closed  and  carefully  dressed.  Any  experimenter 
leaving  wounds  wide  open  and  undressed  as  are  those  in 
these  dogs  would  invite  failure  in  every  case,  and  when  he 
published  his  results  and  had  to  confess  to  a  high  and 
needless  mortaUty,  he  would  discredit  himself. 

One  of  these  dogs  shows  an  absurd  operation  in  the 
neck.  The  great  blood-vessels  from  the  right  and  left  sides 
of  the  neck  have  been  drawn  together  in  front  of  the  wind- 
pipe and  then  tied  —  a  procedure  that  is  unimaginable  to 
any  surgeon.  Moreover,  from  the  wide-open  abdomen  and 
pelvis  the  following  organs  have  been  removed:  the 
stomach,  all  the  large  and  small  intestines,  except  a  portion 
a  few  inches  long,  the  spleen,  the  pancreas,  both  the  kid- 
neys and  the  bladder.  The  liver,  however,  is  left.  Cannot 
even  any  non-medical  person  of  ordinary  intelligence  see 
that  if  all  these  organs  were  really  removed  and,  in  addi- 
tion, the  great  blood-vessels  of  the  neck  on  both  sides  were 
really  tied,  thus  cutting  off  almost  all  of  the  blood-supply 
to  the  brain,  and  then  the  neck  and  the  abdomen  were  left 
wide  open,  the  death  of  the  animal  on  the  table  would  be 
inevitable? 

About  a  dozen  medical  men,  all  teachers  in  medical 


AND  MEDICAL  PROGRESS  273 

schools,  after  careful  inspection  of  these  dogs,  unite  in 
believing  that  all  or  nearly  all  of  these  mutilations  must 
have  been  done  post  mortem  and  not  during  life.  More- 
over, there  is  no  evidence  that  these  animals  were  really 
"vivisected,"  that  is,  operated  on  during  life. 

Still  further,  granting  that  all  these  operations  were 
done  for  research  and  during  life,  if  the  animals  were 
etherized  no  pain  would  have  been  felt  and  no  cruelty 
perpetrated.  The  significant  omission  to  say  anything  as 
to  any  anesthetic,  like  the  omission  as  to  the  restoration 
to  its  owner  of  the  stolen  dog,  entirely  misleads  the  public. 

Dr.  Henry  P.  Bowditch*  quotes  an  extraordinary  state- 
ment of  the  late  Henry  Bergh,  an  ardent  antivivisectionist. 
Mr.  Bergh  says :  — 

Robert  MacDonald,  M.D.,  on  being  questioned,  declared  that 
he  had  opened  the  veins  of  a  dying  person  y  remember,  and  had 
injected  the  blood  of  an  animal  into  them  many  times  and  had 
met  with  brilliant  success.  In  other  words,  this  potentate  has 
discovered  the  means  of  thwarting  the  decree  of  Providence 
when  a  person  was  dying,  and  snatching  away  from  its  Maker 
a  soul  which  He  had  called  away  from  earth. 

I  have  happily  been  able  to  rescue  quite  a  number  of 
dying  persons  who  but  for  my  timely  aid  would  have 
been  dead  persons.  Instead  of  supposing  that  I  had 
"thwarted  the  decrees  of  Providence  and  snatched  a  soul 
from  its  Maker,"  I  have  always  been  under  the  impres- 
sion: (1)  that  it  was  not  in  my  feeble  power  to  thwart 
the  decrees  of  the  Almighty,  and  (2)  the  very  fact  that 
I  was  able  to  save  a  dying  person  from  death  was  the  best 
evidence  that  the  decree  of  Providence  was  that  the 
patient  at  that  time  should  live  and  not  die. 

But  it  seems  that  in  the  catechism  of  antivivisection  it  is 
an  impious  crime  to  save  the  life  of  a  dying  person,  though 
I  suppose  it  is  proper  to  save  the  Ufe  of  a  patient  who  is 
only  "sick." 

*  Henry  P.  Bowditch,  Animal  Experimentation,  p.  72. 


274  ANIMAL  EXPERIMENTATION 

In  the  "Journal  of  Zoophily"  for  April,  1910,  p.  44, 
under  the  caption  "Still  More  Barbarity,"  is  an  editorial 
signed  "C.  E.  W.,"  the  initials  of  the  editor-in-chief.  In 
this  editorial  it  is  stated  as  to  certain  experiments  of 
Dr.  Wentworth,  of  Boston,  that  they  were  "upon  between 
forty  and  fifty  Httle  children  in  the  Children's  Hospital 
of  that  city,  every  one  of  whom  died  after  the  performance 
of  his  operation."  The  "casual  reader"  would  certainly 
understand  that  every  one  of  these  forty  to  fifty  children 
died  as  a  result  of  the  operation. 

Let  us  see  what  the  real  facts  are.^  In  1895,  in  a  case  of 
possible  tuberculous  meningitis.  Dr.  Wentworth  did  lum- 
bar puncture  in  order  to  make  a  positive  diagnosis.  Lum- 
bar puncture  consists  in  introducing  a  rather  long  hypo- 
dermic needle  between  the  vertebrae  in  the  small  of  the 
back  (lumbar  region)  and  withdrawing  some  of  the  fluid 
from  around  the  spinal  cord.  This  fluid  circulates  freely 
to  and  fro  both  within  the  brain  and  its  membranes  and 
within  the  membranes  of  the  spinal  cord.  The  needle  is 
inserted  below  the  end  of  the  spinal  cord,  rarely  with  gen- 
eral anesthesia,  sometimes  with  local  anesthesia  of  the 
skin,  but  generally  without  even  this,  as  the  pain  is  slight 
and  only  momentary. 

In  1895  this  method  of  diagnosis  was  very  new.  Its 
value  was  uncertain,  its  dangers,  if  any,  were  not  deter- 
mined. The  appearance  of  the  fluid  and  the  nature  of  its 
microscopic  contents  in  human  beings  were  imperfectly 
known.  Dr.  Wentworth  in  this  case  used  the  method  for 
diagnosis.  Alarming  symptoms  appeared,  but  passed 
away.  The  child  was  proved  not  to  have  meningitis  and 
"  left  the  hospital  shortly  afterward  perfectly  well." 

In  order  to  determine  whether  this  case  was  exceptional, 

and  the  dangers  only  accidental,  or  always  to  be  feared 

(which  if  true  might  compel  the  entire  abandonment  of 

lumbar  puncture),  he  repeated  the  operation  most  cau- 

*  Boston  Med.  and  Surg.  Jour.,  August  6  and  13,  1896. 


AND  MEDICAL  PROGRESS  275 

tiously  at  first  and  finally  with  surer  faith  in  its  safety  and 
value  in  twenty-nine  other  cases.  In  fifteen  of  the  thirty 
cases  the  puncture  was  expressly  done  in  order  to  make  a 
diagnosis  —  meningitis  or  other  diseases  of  the  brain  and 
spinal  cord  being  suspected.  In  the  other  fifteen  cases, 
while  there  probably  was  no  cerebral  or  spinal  disease,  it 
was  of  great  importance  to  know  whether  examination  of 
the  cerebro-spinal  fluid  might  throw  any  unexpected  side- 
light on  these  diseases,  and  if  not,  it  would  at  least  disclose 
what  the  normal  condition,  appearance  and  microscopic 
contents  of  the  fluid  were. 

Forty-five  punctures  in  all  were  made  on  the  thirty 
children.  In  three  cases  the  puncture  was  made  after 
death.  Of  the  twenty-seven  living  children,  fourteen  died. 
Not  one  of  the  fourteen  died  from  the  operationy  but,  as  the 
post  mortems  showed,  from  meningitis,  tuberculosis,  pneu- 
monia, water  on  the  brain,  convulsions,  etc.,  as  is  ex- 
pressly stated  in  each  case  in  the  paper. 

But  the  editorial  says  "between  forty  and  fifty  little 
children  .  .  .  every  one  of  whom  died  after  the  performance 
of  the  operation."  I  have  before  me  several  anti vivisection 
pamphlets  published  in  New  York,  Philadelphia  and  Wash- 
ington in  which  Wentworth's  cases  are  narrated  as  cases  of 
"human  vivisection,"  and  it  is  usually  stated  that  "many 
of  them  died,"  but  the  reader  would  still  suppose  that  it 
was  as  a  result  of  the  operation.  In  two  of  these  pamphlets, 
"brief  abstracts"  of  five  cases  are  given,  usually  only  one 
to  three  lines  long.  The  post-mortem  reports  published  in 
Wentworth's  paper  showed  that  these  five  patients  died 
from  meningitis  (two  cases),  infantile  wasting,  tuberculosis 
and  defective  development  of  the  brain  and  convulsions. 
Yet  the  "casual  reader"  would  inevitably  suppose  that 
they  died  from  the  lumbar  puncture  as  no  other  cause  of 
death  is  stated  in  these  pamphlets. 

When  Dr.  Cannon  pointed  out  the  inaccuracy  of  the 
editorial  of  April,  1910,  in  the  "Journal  of  Zoophily,"  that 


276  ANIMAL  EXPERIMENTATION 

same  journal  in  the  issue  for  July,  1911,  p.  219,  in  a  paper 
signed  "M.  F.  L."  (the  initials  of  its  associate  editor)  not 
only  did  not  acknowledge  the  error,  but  practically  re- 
peated it  by  saying  that  Dr.  Cannon  is  "severe  on  the 
*  Journal  of  Zoophily*  for  having  referred  last  year  to  Dr. 
Wentworth's  forty-five  experiments  on  children  and  for 
having  mentioned  the  fact  that  the  children  died  after  the 
operation''  [italics  mine]. 

Is  it  fair  dealing  to  give  such  very  brief  abstracts  and 
omit  the  most  important  facts  as  is  done  here?  In  1901 
I  pointed  out^  these  misstatements  and  what  the  truth 
was,  but  the  same  pamphlets  have  been  constantly  dis- 
tributed without  any  correction.  In  November,  1910, 
nearly  ten  years  after  I  had  exposed  the  matter.  Dr. 
Cannon  states  that  one  of  these  pamphlets  was  sent  to 
a  friend  of  his  with  a  letter  from  the  president  of  the  New 
York  Antivivisection  Society,  saying,  "You  may  rely  on 
them  as  being  absolutely  accurate  and  authentic!"  Still 
worse:  In  April,  1910,  "C.  E.  W."  enlarges  the  number 
from  thirty  to  "between  forty  and  fifty"  and  actually  says 
that  "every  one"  of  them  died,  and  "M.  F.  L."  practically 
repeats  the  misstatement  by  saying  that  "the  children 
died  after  the  operation."  ^ 

Suppose  thirty  friends  dined  together  at  the  Bellevue- 
Stratford,  then  took  a  train  and  as  a  result  of  a  collision 
fourteen  were  killed;  would  a  reporter,  and  still  less  an 

1  "Misstatements  of  Antivivisectionists,"  Jour.  Am.  Med.  Ass'n.,  Feb- 
ruary 23  and  August  10, 1901.  (See  ante,  pp.  110  and  135  of  this  volume.) 

2  In  Mrs.White's  reply  to  this  address  (p.  144),  she  "pleads  guilty"  to 
the  charge  of  misstating,  as  to  these  children,  "that  they  all  died,"  and 
says  she  "unconsciously  exaggerated."  On  page  143  she  states  that  she  is 
"most  particular  to  avoid  not  only  falsehood,  but  even  exaggeration." 
It  is  hardly  correct  to  say  that  the  statement  that  there  were  "between 
forty  and  fifty  children"  and  that  "they  all  died"  is  an  "exaggeration" 
of  the  real  fact,  namely,  that  there  were  only  twenty-seven  living  children 
operated  on,  and  of  the  fourteen  who  died,  not  one  of  them  died  from  the 
operation,  but  from  well-known  causes  revealed  by  the  post-mortem 
examinations  and  fully  stated,  in  each  case,  in  Dr.  Wentworth's  paper. 


AND  MEDICAL  PROGRESS  277 

editor,  be  justified  in  stating  in  print,  "Between  forty 
and  fifty  friends  dined  last  night  at  the  Bellevue-Stratford. 
Every  one  died  shortly  after  partaking  of  the  dinner," 
entirely  omitting  the  collision  as  the  real  cause  of  death? 

Now,  after  fifteen  years,  what  has  been  the  result  of 
these  investigations  by  Dr.  Wentworth  and  others? 
Lumbar  puncture  is  a  thoroughly  well-established  means 
of  diagnosis.  That  it  is  attended  with  practically  no  danger 
is  shown  by  the  fact  that  it  is  now  a  routine  practice  in 
certain  diseases,  even  much  more  important  than  recording 
the  pulse  and  the  temperature.  Holmes^  states  that  he 
has  done  the  operation  "over  four  hundred  times  and  has 
never  met  with  an  accident." 

It  is  not  only  always  done  in  some  diseases,  but  is 
repeated  two,  three  or  more  times  in  the  same  patient  in 
cases  of  cerebro-spinal  meningitis.  As  I  showed  in  my 
paper  in  the  "Ladies' Home  Journal"  (April,  1910), 2  the 
son  of  then  Governor,  now  Mr.  Justice  Hughes,  of  the 
United  States  Supreme  Court,  a  student  at  Brown  Uni- 
versity, stricken  with  a  violent  attack  of  the  epidemic  form 
of  the  disease,  had  lumbar  puncture  done  three  times; 
the  first  time  in  order  to  make  a  diagnosis  and  also  for 
the  injection  of  Flexner*s  serum,  the  second  and  third 
times  for  two  other  injections  of  the  serum,  which  snatched 
him  from  otherwise  practically  certain  death. 

In  this  disease,  Royer^  says,  "It  is  absolutely  necessary 
to  do  a  lumbar  puncture"  to  make  a  diagnosis,  and  Dunn* 
says  emphatically,  "Without  lumbar  puncture  a  diagnosis 
of  cerebro-spinal  meningitis  is  absolutely  without  value 
for  scientific,  statistical  or  therapeutic  purposes." 

As  there  are  half  a  dozen  different  forms  of  meningitis, 
and  the  remedy  for  the  deadly  epidemic  form  is  of  no  use 

1  Holmes,  Arch.  PediaL,  October,  1908,  p.  738. 

2  "What  Vivisection  has  done  for  Humanity,"  antet  p.  220. 

3  Royer,  Arch.  Pediat,  October,  1908,  p.  729. 

*  Charles  Hunter  Dunn,  Am.  Jour.  Dis.  CAiWren, February,  1911,  p.  95. 


£78  ANIMAL  EXPERIMENTATION 

in  the  other  forms,  lumbar  puncture,  the  only  absolutely 
positive  means  of  differentiating  them,  cannot  be  dispensed 
with. 

Moreover,  its  use  has  been  broadened,  as  shown  in  the 
case  of  young  Mr.  Hughes.  No  longer  are  we  content  to 
use  it  merely  as  a  means  of  diagnosis,  but  it  is  the  (mly 
means  of  successful  treatment  of  that  terribly  fatal  malady. 
It  is  also  used  for  diagnosis  in  several  surgical  diseases  and 
injuries.  Moreover,  the  method  of  spinal  anesthesia,  which 
is  most  useful  in  cases  in  which  other  methods  of  anesthesia 
are  too  dangerous,  is  exclusively  by  means  of  lumbar 
puncture,  the  cocain  or  other  local  anesthetic  being  injected 
around  the  spinal  cord  by  the  hypodermic  syringe.^ 

When  a  witness  is  called,  it  is  not  allowable  for  the  party 
calling  him  to  accept  a  part  of  his  testimony  and  refuse 
to  accept  the  rest,  yet  this  is  precisely  what  the  opponents 
of  research  do.  They  always  cite,  for  example,  the  late 
Professor  Bigelow,  printing  his  earlier  utterances  based 
on  the  suffering  he  saw  at  Alfort  in  the  pre-anesthetic  days, 
but  they  carefully  omit  the  following  later  expression  of 
opinion:  2  — 

The  dissection  of  an  animal  in  a  state  of  insensibility  is  no 
more  to  be  criticized  than  is  the  abrupt  killing  of  it,  to  which 
no  one  objects.  The  confounding  of  a  painful  vivisection  and 
an  experiment  which  does  not  cause  pain  —  either  because  the 
animal  is  under  ether,  or  because  the  experiment  itself  is  pain- 
less, like  those  pertaining  to  the  action  of  most  drugs,  or  because 
it  is  a  trivial  one  and  gives  little  suffering  —  has  done  great 
damage  to  the  cause  of  humanity,  and  has  placed  the  opponent 
of  vivisection  at  a  great  disadvantage.  ...  A  painless  experi- 
ment on  an  animal  is  unobjectionable. 

^  Those  who  wish  to  consult  by  far  the  best  statement  for  general  use 
of  the  steps  by  which  epidemic  meningitis  has  been  conquered,  and  the 
results  of  the  new  but  now  thoroughly  well-established  serum  treatment 
by  lumbar  puncture,  can  obtain  a  copy  of  Dunn's  paper  on  this  subject. 
No.  21  of  the  series  in  Defense  of  Research.   (See  pp.  xix,  xx.) 

2  Henry  J.  Bigelow,  Anesthesia:  Addresses  and  Other  Papers,  Boston, 
1900.  p.  371. 


AND  MEDICAL  PROGRESS  279 

So,  too,  when  the  statements  of  Horsley,  Ott,  Crile, 
and  others  that  the  animals  were  anesthetized  and  suffered 
no  pain  are  shown  to  antivivisectionists,  they  reply,  "We 
do  not  believe  it,  for  the  only  testimony  to  this  insensibility 
to  pain  is  that  of  the  vivisectors  themselves."  They  greed- 
ily accept  as  true  all  their  other  statements  as  to  the  opera- 
tions they  did,  etc.,  down  to  the  minutest  details,  but  they 
refuse  to  accept  those  as  to  anesthesia.  No  court  of  law 
would  sanction  such  a  course. 

In  reviewing  the  preceding  misstatements  and  those 
quoted  in  my  former  papers,^  I  have  been  compelled  to 
conclude  that  it  is  not  safe  to  accept  any  statement  which 
appears  in  antivivisection  literature  as  true,  or  any  quota- 
tion or  translation  as  correct,  until  I  have  compared  them 
with  the  originals  and  verified  their  accuracy  for  myself. 
Not  seldom  this  is  impossible,  as  no  reference  to  the  volume, 
month,  day  or  sometimes  even  the  year  of  publication  is 
given. 

Lest  the  reader  think  this  too  severe  a  statement  I 
will  refer  to  only  one  instance  in  the  anonymous  pamphlet, 
"Human  Vivisection,"  in  addition  to  others  already  shown 
to  be  grossly  inaccurate. 

On  page  9  in  the  account  of  Sanarelli's  five  experiments 
in  the  endeavor  to  inoculate  yellow  fever,  the  phrase  "the 
final  collapse"  appears  as  an  alleged  translation  of  the 
original  Italian.  The  word  ^' final**  does  not  occur  in  the 
original.  Moreover,  the  collapse  was  not  "final,"  for  every 
one  of  the  five  patients  recovered,  yet  the  pamphlet  says 
that  "some  if  not  all  of  them  died."  The  phrases  "scien- 
tific murder"  and  "scientific  assassination"  are  also  freely 
used.  Even  the  cover  and  the  title-page  of  this  pamphlet 
have  as  a  motto,  "Is  scientific  murder  a  pardonable 
crime?"  As  not  a  single  patient  died,  were  they  really 
"murdered"  or  "assassinated"? 

^  "  Misstatements  of  Antivivisectionists,"  Jour.  Am.  Med.  Assn.,  Febru- 
ary 23  and  August  10,  1901.    (See  ante,  pp.  110  and  135  in  this  volume.) 


280  ANIMAL  EXPERIMENTATION 

Conclusions 

In  thirty  years  the  sixteen  British  antivivisection  socie- 
ties have  received  more  than  £100,000  ($500,000)  ac- 
cording to  Mr.  Stephen  Coleridge's  testimony  before  the 
Royal  Commission  on  Vivisection  (Questions  10256  to 
10260).  The  American  societies  have  had  many  bequests 
given  to  them,  and  in  the  aggregate  must  have  also  spent 
a  large  sum  of  money. 

On  the  other  side,  the  friends  of  research  and  progress 
have  had  little  money,  have  had  to  stop  research  and 
waste  a  deal  of  precious  time  in  defending  their  be- 
neficent researches  from  the  attacks  of  the  antivivisec- 
tionists;  the  rest  of  the  time  they  have  quietly  gone  about 
their  business,  adding  to  the  sum  of  our  knowledge  and 
forging  new  and  more  efl&cient  weapons  against  disease 
and  death. 

What,  then,  is  the  net  result?  What  have  the  friends 
of  research  accomplished,  and  what  achievements  can  the 
foes  of  research  show?  Let  me  put  it  in  a  contrasted  tabu- 
lar form  and  confine  it  to  what  has  occurred  during  my 
own  professional  life. 

The  Achievements  of  the  Friends  of  Research 

1.  They  have  discovered  and  developed  the  antiseptic 
method  and  so  have  made  possible  all  the  wonderful  results 
of  modem  sui^ery. 

2.  They  have  made  possible  practically  all  modem 
abdominal  surgery,  including  operations  on  the  stomach, 
intestines,  appendix,  liver,  gall-stones,  pancreas,  spleen, 
kidneys,  etc. 

3.  They  have  made  possible  all  the  modem  surgery 
of  the  brain. 

4.  They  have  recently  made  possible  a  new  surgery  of 
the  chest,  including  the  surgery  of  the  heart,  lungs,  aorta, 
esophagus,  etc. 


AND  MEDICAL  PROGRESS  281 

5.  They  have  almost  entirely  abolished  lockjaw  after 
operations  and  even  after  accidents. 

6.  They  have  reduced  the  death-rate  after  compound 
fractures  from  two  out  of  three,  i.e.,  sixty-six  in  a  hundred, 
to  less  than  one  in  a  hundred. 

7.  Theyt  have  reduced  the  death-rate  of  ovariotomy 
from  two  out  of  three,  or  sixty-six  in  a  hundred,  to  two 
or  three  out  of  a  hundred. 

8.  They  have  made  the  death-rate  after  operations  like 
hernia,  amputation  of  the  breast,  and  of  most  tumors  a 
negligible  factor. 

9.  They  have  abolished  yellow  fever  —  a  wonderful 
triumph.^ 

10.  They  have  enormously  diminished  the  ravages  of  the 
deadly  malaria,  and  its  abolition  is  only  a  matter  of  time. 

11.  They  have  reduced  the  death-rate  of  hydrophobia 
from  twelve  or  fourteen  per  cent  of  persons  bitten  to  0.77 
per  cent. 

12.  They  have  devised  a  method  of  direct  transfusion 
of  blood  which  has  already  saved  very  many  lives. 

13.  They  have  cut  down  the  death-rate  in  diphtheria 
all  over  the  civilized  world.  In  nineteen  European  and 
American  cities  it  has  fallen  from  79.9  deaths  per  hundred 
thousand  of  population  in  1894,  when  the  antitoxin  treat- 
ment was  begun,  to  nineteen  deaths  per  hundred  thousand 
in  1905  —  less  than  one  quarter  of  its  death-rate  before  the 
introduction  of  the  antitoxin. 

14.  They  have  reduced  the  mortality  of  the  epidemic 
form  of  cerebro-spinal  meningitis  from  seventy-five  or  even 
ninety  odd  per  cent  to  twenty  per  cent  and  less. 

*  Mrs.  White,  in  her  letter  (p.  144),  argues  that  this  statement  is  in- 
correct because,  forsooth,  yellow  fever  "is  still  flourishing  in  a  number* 
of  places  in  South  America,  Central  America,  and  Mexico."  Of  course  it 
is,  but  all  the  worid  knows  that  if  they  adopted  the  methods  of  Colo- 
nel Gorgas  in  the  Canal  Zone,  yellow  fever  would  soon  be  banished  from 
these  other  places.  Since  May  17, 1906,  —  over  eight  years,  —  not  a  sin- 
gle case  of  yellow  fever  has  originated  on  the  Isthmus! 


282  ANIMAL  EXPERIMENTATION 

15.  They  have  made  operating  for  goiter  almost  per- 
fectly safe. 

16.  They  have  assisted  in  cutting  down  the  death-rate 
of  tuberculosis  by  from  thirty  to  fifty  per  cent,  for  Koch's 
discovery  of  the  tubercle  bacillus  is  the  cornerstone  of  all 
our  modem  sanitary  achievements. 

17.  In  the  British  Army  and  Navy  they  have  abolished 
Malta  fever,  which,  in  1905,  before  their  researches, 
attacked  nearly  thirteen  himdred  soldiers  and  sailors.  In 
1907  there  were  in  the  army  only  eleven  cases;  in  1908,  five 
cases;  in  1909,  one  case. 

18.  They  have  almost  abolished  childbed  fever,  the 
chief  former  peril  of  maternity,  and  have  reduced  its 
mortality  from  five  or  ten  up  even  to  fifty-seven  in  every 
hundred  mothers  to  one  in  twelve  hundred  and  fifty 
mothers. 

19.  They  have  very  recently  discovered  a  remedy 
which  bids  fair  to  protect  innocent  wives  and  unborn 
children,  besides  many  others  in  the  community  at  large, 
from  the  horrible  curse  of  syphiUs. 

20.  They  have  discovered  a  vaccine  against  typhoid 
fever,  which  among  soldiers  in  camps  has  totally  abolished 
typhoid  fever,  as  President  Taft  has  so  recently  and  so 
convincingly  stated.  The  improved  sanitation  which  has 
helped  to  do  this  is  itself  largely  the  result  of  bacteriologic 
experimentation. 

21.  They  are  gradually  nearing  the  discovery  of  the 
cause,  and  then  we  hope  of  the  cure,  of  those  dreadful 
scourges  of  humanity,  cancer,  infantile  paralysis^  and 
other  children's  diseases. 

Who  that  loves  his  fellow  creatures  would  dare  to  stay 
the  hands  of  the  men  who  may  lift  the  curse  of  infantile 
paralysis,  scarlet  fever,  and  measles  from  our  children 

*  Since  this  was  written  (1912),  the  germ  of  infantile  puralysis  has 
been  discovered  at  the  Rockefeller  Institute  —  that  Institute  so  hated 
of  all  Antivivisectionists. 


AND  MEDICAL  PROGRESS  283 

and  of  cancer  from  the  whole  race?  If  there  be  such  cruel 
creatures,  enemies  of  our  children  and  of  humanity,  let 
them  stand  up  and  be  counted. 

22.  As  Sir  Frederick  Treves  has  stated,  it  has  been  by 
experiments  on  animals  that  our  knowledge  of  the  path- 
ology, methods  of  transmission,  and  the  means  of  treat- 
ment of  the  fatal  "sleeping  sickness"  of  Africa  has  been 
obtained  and  is  being  increased. 

23.  They  have  enormously  benefited  animals  by  dis- 
covering the  causes  and,  in  many  cases,  the  means  of  pre- 
venting tuberculosis,  rinderpest,  anthrax,  glanders,  hog 
cholera,  chicken  cholera,  lumpy  jaw,  and  other  diseases  of 
animals,  some  of  which  also  attack  man.  If  the  suffer- 
ing dumb  creatures  could  but  speak,  they,  too,  would  pray 
that  this  good  work  should  still  continue  unhindered. 

In  April,  1914,  when  Mr.  Rockefeller  gave  $1,000,000 
to  extend  the  work  of  the  Rockefeller  Institute,  to  the 
study  of  animal  diseases  in  a  laboratory  to  be  established 
in  New  Jersey,  the  antivivisectionists  persuaded  the 
Governor  to  veto  the  bill  authorizing  this  eminently 
humane  work ! 

The  Achievements  of  the  Foes  of  Research 

1.  Not  a  single  human  hfe  has  been  saved  by  their  efforts. 

2.  Not  a  single  beneficent  discovery  has  been  made  by 
them. 

3.  Not  a  single  disease  has  been  abated  or  abolished  by 
them  either  in  animals  or  man. 

4.  All  that  they  have  done  is  to  resist  progress  —  to 
spend  $500,000  in  thirty  years  in  Great  Britain  alone, 
and  very  large  amounts  of  money  in  the  United  States 
— and  to  conduct  a  campaign  of  abuse  and  gross  misrepn 
resentation. 

5.  They  apparently  care  little  or  nothing  for  the  contin- 
ued suffering  and  death  of  human  beings,  the  grief  and 
not  seldom  the  ensuing  poverty  of  their  families,  provided 


284  ANIMAL  EXPERIMENTATION 

that  twenty-six  out  of  every  thousand  dogs  and  cats, 
monkeys  and  guinea-pigs,  mice,  and  frogs  experimented 
on  shall  escape  some  physical  suffering. 

6.  They  insist,  therefore,  that  all  experimental  research 
on  animals  shall  stop  and  —  astoimding  cruelty  —  that 
thousands  of  human  beings  shall  continue  year  after  year 
to  suffer  and  to  die. 

The  Age  of  Experiment  is  the  Age  of  Progress.  This  is 
true  in  mechanics,  in  engineering,  in  electricity,  in  every 
department  of  human  knowledge  in  which  experimental 
investigation  is  possible. 

Medicine  is  no  exception.  Stop  experiment  and  you 
stop  progress.  But  while  stopping  progress  in  other  depart- 
ments only  means  that  we  shall  have  no  further  develop- 
ment in  the  external  comforts  and  conveniences  of  life,  the 
arrest  of  the  experimental  method  in  medicine  means  that 
progress  in  the  knowledge  of  the  cause  and  cure  of  disease 
shall  stop  and  that  our  present  sufferings  and  sorrowful 
bereavements  from  the  onslaught  of  cancer,  scarlet  fever, 
measles,  whooping-cough,  and  all  the  other  foes  of  health 
and  life  —  especially  of  our  dear  children  —  must  con- 
tinue. 

In  the  last  fifty  years,  by  experimental  methods,  we  have 
made  more  progress  than  in  the  preceding  fifty  centuries. 
I  believe  that  if  experimental  research  is  continued  and 
aided,  the  next  fifty  years  will  be  still  more  prolific  of 
benefit  to  mankind  than  even  the  past  fifty. 

I  have  absolute  confidence  in  the  humanity,  the  in- 
telligence, and  the  common  sense  of  this  nation  that 
they  will  see  to  it  that  this  progress  shall  not  be  halted 
by  the  outcries  and  misstatements  of  the  antivivisec- 
tionists. 

Dr.  S.  Weir  Mitchell,  when  visiting  the  Antivivisection 
Exhibition  in  Philadelphia,  put  the  matter  in  a  nutshell 
when  he  said  to  one  of  the  guides,  "Your  exhibition  is  not 


AND  MEDICAL  PROGRESS  285 

quite  complete.  You  should  place  here  a  dead  baby  and 
there  a  dead  guinea-pig  with  the  motto,  "Choose  between 
them/'i 

*  Of  course,  not  all  antivivisectionists  are  to  be  grouped  with  those 
who  are  responsible  for  the  letters,  the  epithets,  and  the  persistent  mis- 
statements mentioned  in  this  paper.  I  have,  for  example,  some  most  es- 
teemed personal  friends  who  are  more  or  less  opposed  to  research  by 
means  of  experiments  on  animals.  But  I  believe  that  most  of  the  reason- 
able persons  who  take  this  stand  are  not  well  informed,  either  as  to  the 
character  of  such  researches,  to  their  profound  importance  to  the  human 
race  and  to  animals,  or  to  their  wonderfully  beneficent  results.  They  are 
misled  by  the  misstatements  of  the  chief  antivivisectionists,  and  their 
kindly  hearts  are  so  shocked  by  the  asserted  "  tortile  "  of  dogs,  cats,  etc., 
that  they  lose  sight  of  the  real  and  horrible  torture  continuously  inflicted 
on  human  beings  by  diseases  which  the  advocates  of  research  are  endeav- 
oring to  banish.  Had  they  ever  stood  as  in  the  past  I  have  stood,  knife 
in  hand,  by  the  bedside  of  a  gasping,  livid  child  struggling  for  breath, 
ready  to  do  a  tracheotomy  when  the  surely  tightening  grip  of  diphtheria 
made  it  necessary  to  interfere,  they  would  hail  with  delight  the  blessed 
antitoxin  which  has  abolished  the  knife  and  enormously  diminished  the 
mortality  of  that  cm-se  of  childhood.  They  would  surely  bless  God  that 
such  a  discovery  as  this  antitoxin  could  be  made  solely  by  experiments  on 
animals.  The  sufferings  of  a  few  such  animals  are  as  nothing  compared 
with  the  lessening  of  suffering  and  saving  of  life  for  multitudes  of  human 
beings  (to  say  nothing  of  the  saving  of  sorrow  and  suffering  to  their  fami- 
lies and  friends),  not  only  now,  but  for  all  time  to  come. 


THE  ANTIVIVISECTION  EXHIBITION  IN 
PHILADELPHIA  IN  1914' 

It  is  difficult  to  write  with  calmness  and  moderation 
about  the  Antivivisection  Exhibition,  since  it  is  such  a  mass 
of  omissions  and  misrepresentations. 

I  protest  against  an  exhibit  which  misleads  the  public 
into  believing  that  operations  on  animals  are  generally 
done  without  anesthetics.  This  is  untrue.  Anesthetics  are 
universally  employed  in  painful  operations  with  the  excep- 
tion of  the  extremely  rare  cases  in  which  their  use  would 
vitiate  the  results.  Moreover,  they  are  so  used  as  to  pro- 
duce total  insensibility  to  pain.  To  animals  under  their 
influence  no  operation  can  cause  any  suffering.  All  persons 
who  have  had  surgical  operations  know  this.  The  omission 
of  the  etherizer,  therefore,  in  pictures  or  descriptions  of 
operations  on  animals  is  not  a  truthful  representation. 
It  wholly  misleads  the  public. 

I  protest  against  the  impossible  operations  represented 
as  the  "vivisected  products  of  Philadelphia  laboratories." 
About  a  dozen  teachers  in  medical  schools,  after  inspecting 
the  same  or  similar  specimens  in  the  exhibition  a  year  ago, 
agreed  with  me  that  they  had  been  probably  done  post 
mortem  and  not  during  life.  There  is  not  the  slightest 
evidence  that  they  were  done  during  life.  They  are  mutila- 
tions the  like  of  which  I  have  never  seen  in  any  laboratory. 
When  wounds  are  made  in  animals  by  surgeons,  physiolo- 
gists or  pathologists,  they  are  closed  with  the  most  minute 
care.  In  this  exhibit  the  wounds  have  been  left  wide  open, 

1  Reprinted  from  the  Public  Ledger  of  December  9,  1913,  by  the 
kind  permission  of  the  editor. 


medical:  progress  287 

and  from  the  abdomen  of  one  dog  nearly  all  the  internal 
organs  had  been  removed  —  an  absurdity  in  itself. 

I  appeal  to  the  knowledge  and  common  sense  of  the 
vast  majority  of  people  who  are  not  deluded  by  the  gross 
misstatements  of  the  antivivisectionists.  If  the  latter  had 
had  their  way  for  the  last  forty  years,  there  would  have 
been  almost  no  progress  in  medicine  and  surgery  and  we 
should  be  practicing  the  old  fatal  sui^ery  in  vogue  before 
Lister's  day.  Then  two  out  of  three  compound  fracture 
cases  died.  Now  less  than  one  in  a  hundred.  Then  ovarian 
tumor  operations  also  had  a  mortality  of  two  out  of  three. 
Now  only  one  or  two  in  a  hundred.  Then  five  to  ten  and 
sometimes  as  many  as  fifty-seven  mothers  out  of  every 
one  hundred  died  in  childbirth  from  childbed  fever.  Now 
only  one  in  twelve  hundred  and  fifty. 

To-day,  in  spite  of  the  overwhelming  testimony  of  really 
competent  medical  men,  the  antivivisectionists  actually 
declare  that  diseases  are  not  caused  by  germs !  Of  course, 
therefore,  they  decry  the  use  of  the  antitoxins  in  diph- 
theria, lockjaw,  epidemic  cerebro-spinal  meningitis,  and 
as  a  preventive  of  typhoid  fever.  Yet  every  well-informed 
physician  and  intelligent  layman  knows  positively  the 
enormous  benefits  of  these  remedies. 

To  show  how  serious  a  menace  to  progress,  to  life  and 
health  the  antivivisectionists  are,  one  of  the  leaflets  in  this 
exhibition  attacks  one  of  the  most  extraordinarily  benefi- 
cent of  recent  researches,  that  upon  the  hypophysis  or 
pituitary  body.  This  little  body,  the  size  of  a  pea,  lies  at 
the  base  of  the  brain  and  is  not  rarely  the  seat  of  disease 
or  of  tumors.  Up  to  only  six  to  eight  years  ago  its  functions 
were  not  known.  By  experiments  upon  animals  these 
functions  are  now  known  to  some  extent  and  found  to  be 
of  vital  importance.  Blindness  is  a  frequent  symptom  of 
such  tumors  and  eventually  life  is  destroyed  unless  an 
operation  is  done. 


288  ANIMAL  EXPERIMENTATION 

It  Is  true  that  the  dogs  experimented  upon  suffered 
pain  and  doubtless  felt  wretched,  for  though  the  operations 
done  upon  them  in  order  to  ascertain  the  functions  of  this 
gland  were  done  under  an  anesthetic,  yet  they  could  not 
be  killed  at  once  or  the  function  of  the  gland  would  not  be 
discovered.  The  only  alternative  is  to  watch  the  clumsy  and 
confusing  experiments  of  disease  in  human  beings.  This 
had  been  done  for  years  without  any  definite  results.  The 
health  and  the  lives  of  the  former  sufferers  from  disease 
of  this  gland  had  been  sacrificed  in  vain.  Many  of  them 
became  cretins  (idiots).  Many  overgrew  and  became  loath- 
some in  appearance  and  wretched  in  health.  Many  became 
blind,  and  many  died. 

Note  now  the  benefits  from  the  experiments  upon  ani- 
mals. Already  more  than  one  hundred  operations  have 
been  done,  with  a  mortality  of  less  than  ten  per  cent.  While 
writing  this  paper.  Dr.  Rodman  E.  Sheen,  a  most  grateful 
young  man  of  twenty-four,  from  Atlantic  City,  has  called 
to  see  me  to  tell  me  of  his  remarkable  case.  In  October, 
1909,  the  sight  of  his  left  eye  began  to  fail.  By  August, 
1912,  this  eye  was  completely  blind  and  the  sight  of  the 
right  eye  was  rapidly  failing.  Only  by  the  kindness  of  his 
fellow  medical  students  could  he  complete  his  medical 
course.  On  March  3,  1913,  Dr.  Harvey  Gushing  removed 
a  tumor  of  this  gland.  Immediately  his  vision  began  to 
improve.  He  can  now  read  large  print  and  his  sight  is 
steadily  growing  still  better.  Without  operation  death 
would  certainly  have  overtaken  him.  Ask  him  if  he  thinks 
that  his  life  and  usefulness  were  not  worth  more  than  the 
sufferings  and  the  fives  of  the  four  dogs  whose  pictures  are 
shown  in  the  antivivisection  leaflet  attacking  these  re- 
searches, and  of  all  the  other  dogs  experimented  upon. 
Do  not  forget  also  that  in  the  future  hundreds  of  other 
patients  also  will  be  saved. 

Would  it  not  be  cruelty  beyond  belief  if  the  search  for 
the  causes  and  means  of  cure  of  cancer,  scarlet  fever. 


AND  MEDICAL  PROGRESS  289 

measles,  mumps,  etc.,  should  be  stopped?  And  yet  this  is 
exactly  what  the  antivivisectionists  are  determined  to  do. 
A  card  on  the  wall  of  the  exhibition  reads :  — 

We  indorse  legitimate  surgery  but  deny  it  has  been  advanced 
through  vivisection. 

(Signed)  The  Amehican  Antivivisection  Society. 

Whose  knowledge,  opinions,  and  statements  as  to  the 
value  of  vivisection  will  you  trust?  Shall  it  be  those 
of  Miss  Lind-af-Hageby,  Mrs.  White,  Mrs.  Lovell,  Mrs. 
Easby,  and  Miss  Nicholson,  the  most  active  members  of 
the  American  Antivivisection  Society,  women  who  have 
never  studied  medicine  thoroughly  if  at  all,  or  those  of 
such  life-long  students  and  leaders  in  medicine  as  S.  Weir 
Mitchell,  Sir  William  Osier,  William  H.  Welch,  of  Johns 
Hopkins;  John  B.  Deaver,  and  men  like  them?  The  very 
question  is  an  absurdity. 

I  have  heard  myself  called  a  "hyena"  before  a  legislative 
committee  at  Harrisbur^.  I  have  received  letters  address- 
ing me  as  "you  fiend"  and  even  "arch-fiend"  and  cursing 
my  sainted  mother  for  ever  giving  me  life.  These  are  not 
pleasant  incidents.  I  would  far  rather  have  the  esteem 
than  the  hatred  of  these  persons,  but  for  one  thing  —  a 
profound  sense  of  the  duty  I  owe  to  my  profession,  and 
above  all  to  present  and  future  generations  of  my  fellow 
men. 

For  more  than  half  a  century  I  have  spent  my  days 
and  nights  in  the  constant  study  of  surgery.  I  have  taught 
it  to  many  thousands  of  students.  I  am  nearing  the  end  of 
a  long  and  laborious  life.  I  have  had  some  small  share  in 
the  wonderful  progress  of  surgery  during  the  last  thirty 
years. 

I  appeal  to  my  fellow  citizens  and  fellow  countrymen  to 
believe  me  when  I  say  that  while  clinical  observation, 
sanitary  engineering,  etc.,  have  done  much  to  make  this 
progress  possible,  the  chief  means  by  which  medicine  and 


290  ANIMAL  EXPERIMENTATION 

surgery  have  won  their  beneficent  triumphs  has  been 
experimental  research.  To  aboHsh  all  such  research,  as  is 
the  declared  aim  of  the  antivivisectionists,  would  be  a  dis- 
aster to  animals  themselves.  MilUons  of  animals  have 
benefited  by  our  knowledge  derived  from  experiments  on 
animals,  by  which  hog  cholera,  chicken  cholera,  rinderpest, 
anthrax,  lumpy  jaw,  and  other  diseases  of  animals  have 
been  checked,  cured  or  abolished. 

It  would  also  be  a  disaster  to  the  whole  human  race  by 
preventing  future  researches  which  will  equal  if  not  sur- 
pass in  value  those  of  past  years.  Our  descendants  must 
not  be  abandoned  to  devastation  and  death  from  diseases, 
the  cause,  prevention,  or  cure  of  which  are  now  unknown. 
The  antivivisectionists  in  my  opinion  are  enemies  of 
animals  and  of  the  whole  human  race. 


THE  END 


SELECTED  QUOTATIONS 


SELECTED  QUOTATIONS 

Lawson  Tait:  — 

"Bacteriological  experiments  on  animals  have  proved  of  great 
value."  1 

Professor  Henry  J.  Bigelow:  — 

"The  dissection  of  an  animal  in  a  state  of  insensibility  is  no 
more  to  be  criticized  than  is  the  abrupt  killing  of  it,  to  which  no 
one  objects.  The  confounding  of  a  painful  vivisection  and  an 
experiment  which  does  not  cause  pain  —  either  because  the 
animal  is  under  ether,  or  because  the  experiment  itself  is  painless, 
like  those  pertaining  to  the  action  of  most  drugs,  or  because  it  is  a 
trivial  one  and  gives  little  suflFering  —  has  done  great  damage  to 
the  cause  of  humanity,  and  has  placed  the  opponent  of  vivi- 
section at  a  great  disadvantage.  ...  A  painless  experiment  on  an 
animal  is  unobjectionable."  * 

Sir  Frederick  Treves:  — 

"  No  one  is  more  keenly  aware  than  I  am  of  the  great  benefits 
conferred  on  suffering  humanity  by  certain  researches  carried 
out  by  means  of  vivisection."  ^ 

Sir  Frederick  Treves:  — 

"This  progress  [in  the  science  of  medicine]  has,  in  the  main, 
been  accomplished  by  experiments  on  animals."  * 

Professor  C.  S.  Sherrington,  of  Liverpool :  — 

"  I  find  in  the  book,  "  The  Nine  Circles,"  three  instances  in 
which  I  am  by  name  and  deed  held  up  to  public  abhorrence. 
From  each  of  the  three  statements  made  about  me  the  employ- 

1  British  Medical  Journal,  February  11,  1893,  p.  317.  See  ante,  p.  xiii 
of  this  volume. 

*  Anesthesia:  Addresses  and  Other  Papers,  Boston,  1900,  p.  371. 

«  London  Times,  April  18,  1902. 

«  British  Medical  Journal,  July  8,  1911,  p.  82. 


294  SELECTED  QUOTATIONS 

ment  of  anesthesia  in  my  experiments  is  studiously  omitted,  al- 
though expressly  mentioned  in  each  of  the  published  papers  on 
which  these  statements  are  professed  to  rest.  In  two  out  of  three 
statements  I  am  accredited  with  inflicting  on  living  animals,  and 
without  the  employment  of  anesthetics,  a  dissection  and  pro- 
cedure that  I  pursued  only  on  animals  which  were  dead.'*  ^ 

Mrs.  Caroline  Earle  White:  — 

"The  best  plan  would  be  for  the  experimenters  to  go  to  India 
where  they  could  find  as  large  a  field  for  investigation  as  they 
require  in  the  poor  victims  themselves.  Here  is  an  opportunity 
such  as  is  not  often  offered  for  experimenting  upon  human  beings, 
since,  as  they  would  invariably  die  from  the  snake-bites,  there  can 
be  no  objection  to  trying  upon  them  every  variety  of  antidote  that  can 
be  discovered.  Nothing  seems  to  me  less  defensible  than  these 
experiments  on  the  poison  of  snake-bites  upon  animals,  since  it  is 
the  one  case  in  which  they  could  be  observed  with  so  much  satis- 
faction and  certainty  upon  man!**   (Italics  my  own.)  ^ 

Mrs.  CaroHne  Earle  White:  — 

"I  take  issue  with  Dr.  Keen  .  .  .  where  he  says,  'These  experi- 
ments cannot,  nay,  must  not,  be  tested  first  upon  man.*  I  assert, 
on  the  contrary,  that  in  the  majority  of  cases  they  must  be 
tested  first  upon  man  or  not  tested  at  all."  ^ 

Unanimous  report  of  the  Royal  Commission  on  Vivisection. 
On  this  commission  the  antivivisectionists  were  represented  and 
joined  in  this  unanimous  report :  — 

"We  desire  to  state  that  the  harrowing  descriptions  and  illus- 
trations of  operations  inflicted  on  animals,  which  are  freely  circu- 
lated by  post,  advertisement,  or  otherwise,  are  in  many  cases  cal- 
culated to  mislead  the  public,  so  far  as  they  suggest  that  the 
animals  in  question  were  not  under  an  anesthetic.  To  represent 
that  animals  subjected  to  experiments  in  this  country  are  wan- 
tonly tortured  would,  in  our  opinion,  be  absolutely  false."  *         * 

*  London  Times,  October  25,  1892. 

2  An  Answer  to  Dr.  Keen's  Address,  entitled  "  Our  Recent  Debts  to  Vivi- 
section," p.  10. 

'  Ibid.,  p.  4.  «  Report,  1912.  p.  20. 


SELECTED  QUOTATIONS  295 

Dr.  Herbert  Snow,  of  London,  as  quoted  by  Mrs.  M.  F. 
Lovell:  — 

"Researeb  among  the  lower  organisms  is  the  main  path  to  be 
followed  in  the  ages  yet  to  be."  ^ 

Dr.  Herbert  Snow,  of  London,  in  his  evidence  before  the  Royal 
Commission  on  Vivisection  answered  326  questions  in  1906.  In 
1911,  he  stated  that  he  gave  all  this  evidence  "in  utter  ignorance 
of  the  vivisection  question."  ^ 

The  Honorable  Stephen  Coleridge,  of  London:  — 

"I  drive  a  motor-car,  and  when  I  go  beyond  the  speed  limit, 

and  the  policeman  asks  me,  I  say,  *No,  I  am  not  going  beyond  the 

speed  limit.' "  ^ 

W.W.  Keen:— 

"These  resolutions — i.e.,  in  favor  of  Experimental  Research 
{vide  pp.  xv-xviii)  —  represent  the  collective  opinion  of  the  medi- 
cal 'profession^  not  only  of  Great  Britain  and  America,  but  of 
the  whole  civilized  world. 

"  Per  contra^  there  is  not,  so  far  as  I  know,  a  single  resolution 
of  any  sdentijic  body  expressing  the  opposite  opinion,"  * 

1  Journal  of  ZodphUi/f  July,  1914,  p.  101. 

*  Dr.  Snow's  letter.  Public  Ledger,  Philadelphia,  March  6,  1911. 
^  Report  of  Royal  Commission  on  Vivisection,  Answer  no.  10,  952. 

*  Preface,  p.  xviii. 


A  LETTER  TO  "LIFE"* 

BY  MR.  CHARLES  H.  FAHS,  MADISON,  NEW  JERSEY 

(This  letter  [by  a  layman,  be  it  observed]  was  sent  to  "Life" 
in  criticism  of  the  attitude  of  that  paper  toward  the  use  of  vac- 
cines, sera,  and  vivisection.  It  was  later  returned  to  the  writer 
as  unavailable.  .  .  .  The  document  is  so  human,  however,  and  is 
such  a  powerful  appeal  against  the  maudlin  sentimentality  of  the 
antivivisectionist  and  antivaccinationist,  that  the  "  Journal  '*  has 
asked  Mr.  Fahs's  permission  to  publish  it.  The  recent  attacks 
of  these  propagandists  against  the  use  of  tuberculin  as  "human 
vivisection"  makes  the  publication  of  this  letter  the  more  timely. 

—  The  Editor.) 

Dear  "Life":  — 

You  take  your  fling,  and  you  must.  That's  your  mission.  But 
listen! 

When  Death  first  struck  near  me,  I  was  but  four  years  old,  and 
it  was  my  little  sister  that  went  —  spinal  meningitis.  Serum 
therapy  was  yet  to  be.  Last  year  my  only  boy  lay  in  convulsions 

—  spinal  meningitis.  A  fast  auto  ride  to  a  Brooklyn  hospital. 
Antimeningitis  serum  used.  Not  another  convulsion  thereafter. 
I  thanked  God  for  Simon  Flexner  and  his  ilk  and  took  courage. 
What  would  you  have  done?  How  would  you  have  felt? 

When  Death  struck  near  me  the  second  time,  it  was  a  baby 
brother  that  went  —  diphtheritic  sore  throat.  Antitoxins  were 
unheard  of  as  yet.  When  I  took  my  family  abroad  for  a  winter 
three  years  ago,  I  felt  easier  when  I  discovered  that  the  German 
town  we  had  chosen  for  our  stay  had  a  high-grade  laboratory 
where  the  diphtheria  antitoxin  had  been  developed.  How  would 
you  have  felt? 

When  Death  struck  near  me  the  third  time,  again  it  was  a 
younger  brother  who  was  claimed  —  infection  following  vaccina- 

^  Reprinted  by  the  kind  pennission  of  the  author  and  of  the  editor 
of  the  Journal  of  the  Outdoor  Life  for  September,  1914. 


A  LETTER  TO   "LIFE"  297 

tion  against  smallpox  which  was  active  near  by.  We  learned 
later  that  the  alleged  doctor  who  did  the  vaccinating  had  neither 
legal  nor  moral  right  to  hang  out  a  shingle,  and  bitterness  was  in 
my  heart.  Two  years  ago  I  was  about  to  start  for  a  long  journey 
through  Asia  where  smallpox  was  to  be  met  with  on  every  high- 
way. In  spite  of  sad  memories,  I  had  myself  vaccinated  before  I 
sailed.   What  would  you  have  done.'^ 

During  the  Spanish  War  I  saw  Death  when  its  name  was 
Legion.  A  score  of  times  on  a  single  afternoon  I  heard  the  muf- 
fled drums  and  saw  the  reversed  arms  as  the  melancholy  pro- 
cessions left  the  fever  hospitals.  Inoculation  for  typhoid  was 
unknown.  On  that  Far  Eastern  trip  of  two  years  ago  I  was  to 
face  possible  typhoid  infection  at  almost  every  meal  time.  I  was 
inoculated  for  typhoid  before  I  started.  What  would  you  have 
done? 

Seven  years  ago,  physically  undone,  I  lay  in  a  hospital  while 
capable  and  faithful  physicians  sought  to  ascertain  the  ob- 
scure cause  of  it  all.  Finally  I  was  asked  whether  I  was  willing  to 
undergo  the  tuberculin  test  (hypodermic)  for  diagnostic  pur- 
poses. I  consented.  The  reaction  was  severe,  but  it  pointed  the 
way,  and  the  subsequent  treatment  for  tuberculous  peritonitis 
brought  me  back  to  health.   Would  you  have  consented  ? 

As  a  lonesome  boy  on  the  farm  I  had  a  collie  as  a  servant, 
companion,  and  pet.  Because  of  disease  he  had  to  be  shot,  and 
my  heart  was  broken.  Never  have  I  had  a  pet  since.  But  I  have 
children,  and  I  am  willing  for  all  the  dogs  and  cats  and  guinea- 
pigs  to  be  sacrificed  if  these  precious  ones  can  be  better  protected 
against  the  hostile  microbes  of  various  kinds  that  have  cost  my 
home  the  life  of  one  child  and  severe  if  not  desperate  illnesses  for 
each  of  the  other  three  within  a  single  year. 

The  profession  of  medicine  has  not  succeeded  in  isolating 
itself  entirely  from  carelessness,  inefficiency,  selfishness,  or  even 
from  hardness  of  heart  with  respect  to  suffering  on  the  part  of 
animals  or  folks,  but  I  know  too  many  physicians  of  a  noble  type, 
men  of  high  worth  in  head  and  hand  and  heart,  to  subscribe  to 
any  broad  indictment  of  the  profession's  personnel  or  processes. 

In  a  word,  "Life,"  I  think  you're  honest,  but  I  don't  think 
you're  fair. 


INDEX 


I 


INDEX 


Abbe,  Dr.  Robert,  his  experiment 
on  the  aorta,  156. 

Abdominal  operations,  5-8,  29-34, 
105,  189,  215;  fever  after,  250  n. 

Abdominal  tumors,  31,  32.  See 
Tumors. 

Abscess,  in  the  loin,  10;  of  the  kid- 
ney, 11,  34;  of  the  brain,  35,  52, 
53,  215;  of  the  lungs,  42,  85,  181; 
condition  of  blood  in,  102,  103; 
Lister's  experiments  on,  208. 

Abusive,  literature  of  antivivisec- 
tionists,  239,  240;  epithets  used 
by  antivivisectionists,  240. 

Achievements,  of  friends  of  research, 
280-83;  of  foes  of  research,  283- 
85. 

Acromegaly,  195. 

Adrenal  gland,  194. 

Adrenalin,  value  of,  154;  and  cocain, 
mixture  of,  173;  Dr.  Hadwen's 
criticism  of  Dr.  Keen's  reference 
to,  249;  source  of,  249. 

Aiken,  Midshipman,  and  vivisec- 
tion, 146-50,  230. 

Air,  not  the  cause  of  inflammation, 
207. 

America,  contributions  to  medicine 
through  vivisection  in,  5,  6,  8. 

American  Antivivisection  Society, 
postal  cards  issued  by,  269;  card 
of,  in  exhibition,  289. 

American  Association  for  the  Ad- 
vancement of  Science,  resolutions 
of,  xvii,  xviii. 

American  Humane  Association,  cor- 
respondence and  controversy 
with,  110-45. 

American  Medical  Association,  reso- 
lutions of,  xvii,  xviii. 

Amputated  leg,  contraction  of,  248. 

Amputation,  illustrations  of,  before 
antisepsis,  23-27,  200-04;  illus- 
tration of,  after  antisepsis,  25-27; 
mortality  of,  27,  215;  injection  of 
cocain  into  nerves  before,  173, 


174;  of  hip- joint,  225;  of  breast, 
for  cancer,  226. 

Anders,  Prof.  J.  M.,  use  of  tuber- 
culin by,  131. 

Anesthesia,  meaning  of  "light  anes- 
thesia," vii,  244;  experiments 
done  before  discovery  of,  vii,  viii; 
important  surgical  discovery  of 
nineteenth  century,  74;  general, 
171,  172;  local,  172-74;  spinal, 
174-76,  278;  Meltzer  and  Auer's 
method  of,  183,  261. 

Anesthetic,  bromid  of  ethyl  as,  10; 
ideal,  10,  176;  effect  of,  on  hemo- 
globin, 103,  104;  use  of,  in  animal 
experimentation,  108,  232,  233; 
used  in  animal  experimentation, 
but  non-use  claimed  by  antivivi- 
sectionists, vi-viii,  244-46,  265- 
68,  273,  278,  279,  286. 

Anesthetic  Delusion,  The,  vi. 

Anesthetized,  meaning  of  the  word, 
245. 

Anesthetizer  of  animals  and  Mrs. 
Easby,  viii. 

Aneurysm,  155,  209. 

Animal  experimentation.  See  Vivi- 
section. 

Animals,  not  different  from  man  in 
structure  and  function,  xii;  bene- 
fited by  vivisection,  20,  109,  283, 
289,  290;  diseases  of,  107;  statis- 
tics of  painfulness  of  experiments 
on,  108,  241,  244,  245,  262,  263, 
266;  experiments  on,  performed 
with  anesthetics,  vi-viii,  108,  232, 
233,  244-46,  265-68,  273,  278. 
279,  286. 

Anthrax,  106,  107. 

Antidote,  for  snake-bites,  9,  148, 
149,  252;  for  exophthalmic  goiter, 
167,  168;  for  tetanus,  197. 

Antidotes,  due  to  vivisection,  45. 

Antisepsis,  Lister's  services  to,  18, 
19,  28,  74-77,  225-27,  255;  prog- 
ress in  surgery  partly  due  to,  22, 


INDEX 


45;  recent'  generalization  of,  23; 
illustration  of  operation  before, 
23,  24,  200-04;  illustration  of  op- 
eration under,  25-27;  mortality 
in  amputations  before  and  after, 
27;  mortality  in  operations  before 
and  after,  225,  226. 

Antiseptic  method,  the  period  pre- 
ceding, 199-204;  discovery  and 
development  of,  204-13;  results 
of,  214-19;  in  three  hospitals,  215- 
18. 

Anti-serum.  See  Antidote,  Anti- 
toxin. 

Antitoxin,  lessening  of  mortality 
from  diphtheria  by  use  of,  9  n., 
73,  232;  for  tetanus,  197;  for 
diphtheria,  231. 

Antivivisection,  influence  of,  on 
character,  234-85. 

Antivivisection,  exhibits,  no  etheri- 
zer shown  in,  viii;  laws  in  Eng- 
land, 9,  12,  19,  28,  148,  149,  208; 
exhibit  in  New  York,  271;  exhibit 
in  Philadelphia,  271,  272,  286-90; 

.    societies,  bequests  to,  280. 

Antivivisectionists,  misstatements 
and  misrepresentations  of,  vi-ix, 
110-45, 120-45,  244,  263-90;  non- 
use  of  anesthetics  falsely  claimed 
by,  vi-viii,  244-46,  265-68,  273, 
278,  279,  286;propose  post-mortem 
examinations,  233;  deny  truths  of 
bacteriology,  250. 

Aorta,  Dr.  Abbe's  experiment  on, 
156;  transplantation  of,  in  dogs, 
162;  Carrel's  work  on,  183,  184. 

Appendicitis,  condition  of  blood  in, 
103. 

"Arch  fiend"  letter,  234-36. 

Arm,  bone,  transplantation  of,  171; 
musculo-spiral  nerve  in,  177, 178; 
birth  palsies  in,  178,  179. 

Army,  typhoid  fever  abolished  in 
our,  x,  259,  260;  vaccination  in 
British,  260  n. 

Arteries,  gunshot  wounds  of,  5,  6; 
surgery  of,  154-59;  divided  suture 
of,  156;  transplantation  of,  after 
cold  storage,  162;  Lister's  experi- 
ments on,  208-11;  method  of 
criss-crossing  discovered  at  Rocke- 
feller Institute,  242. 

Aseptic,  199  n. 


Asphyxia,  danger  from,  in  use  of 
nitrous  oxid,  172. 

Assassination,  scientific,  125,  279. 

Association,  British  Medical,  reso- 
lution of,  XV,  xvi,  71;  and  Mid- 
land Medical  Society,  resolution 
of,  and  Lawson  Tait,  xiii. 

Atlee,  Dr.  Washington  L.,  225. 

Auer.   See  Meltzer. 

Authorities,  newspapers  as,  116-18, 
138. 

Bacteria,  purulent,  128. 

Bacteriology,  of  tuberculosis,  14, 15, 
73;  its  contribution  to  treatment 
of  compound  fractures,  29;  value 
of,  admitted  by  Lawson  Tait,  xiii, 
71 ;  what  it  has  shown,  73 ;  of  lock- 
jaw, 74 ;  services  of,  226 ;  truths  of, 
denied  by  antivivisectionists,  250. 

Baking  animals  alive,  8,  271. 

Bennett,  Dr.  Hughes,  13,  35. 

Bequests  to  antivivisection  socie- 
ties, 280. 

Berdoe,  Dr.,  accuracy  of,  248,  265; 
his  excuses  for  misstatements, 
266. 

Bergh,  Henry,  extraordinary  state' 
ment  of.  273. 

Berkley,  Dr.,  his  experiments  on 
the  insane,  120,  121,  133,  134. 

Bigelow,  Dr.  Henry  J.,  his  two 
views  of  vivisection,  xii,  244,  278; 
his  view  of  painless  vivisection, 
293. 

Bile,  the,  191. 

Birth  palsies,  178. 

Black  Art  of  Vivisection,  264. 

Bladder,  removal  of,  6. 

Blood,  examination  of,  102;  leuco- 
cytosis,  102,  103;  hemoglobin, 
103,  104;  freezing  temperature  of, 
104;  coagulation  time  of,  104; 
clot,  156,  157, 185;  transfusion  of, 
157-59,  223,  224,  242. 

Blood  poisoning.   See  Pyemia. 

Blood  vessels,  clots  in,  156, 157,  223, 
224;  suture  of,  158,  223;  in  chest, 
wounds  of,  184. 

Bone,  transplantation  of,  98-102, 
160-62,  171. 

Boston  Transcript,  The,  the  Wash- 
ington correspondent  of,  125, 126. 

Bowditch,  Henry  P.,  247,  248,  273. 


INDEX 


303 


Bowel.   See  Intestines. 

Bowlegs,  42. 

Brain,  result  of  experiments  of 
Ferrier  and  others  on,  12,  13; 
tumors  of,  diagnostication  and 
removal  of,  13,  14.  35,  53-57, 63, 
64, 174, 215;  abscess  of,  35,52,  53, 
215;  hemorrhage  of,  36, 57-60, 81, 
146-48,  230;  gunshot  wounds  of, 
36;  surgery  in  cases  of  epilepsy, 
36,  37;  localization  of  its  centers, 
37-39,  46-50,  62-70,  80;  cannot 
feel  pain,  38,  69;  motor  area,  37- 
39,  46-50,  79,  80;  surgery  of,  and 
vivisection,  45-71;  fissures  of,  48- 
50;  fissures  of,  how  located  on 
skull,  49,  50;  statistics  of  tumors 
of,  56,  57;  question  of  transfer- 
'  ence  of  tissue  of,  69,  70. 

Breast,  amputation  of,  for  cancer, 
226. 

Bregy,  Judge,  xiv. 

British  Medical  Association,  resolu- 
tion of,  xiii,  XV,  xvi,  71. 

British  Medical  Journal,  268. 

British  Royal  Commission  on  Vivi- 
section, report  of,  xviii,  233,  241, 
247,  294.  ^ 

Britton,  Miss,  describes  operation 
which  was  never  done,  270,  271. 

Bromid  of  ethyl,  10. 

Bronchoscopy,  182. 

Brown,    James    M.,    President    of 

American  Humane  Association, 

correspondence  and  controversy 

of,  with  Dr.  W.  W.  Keen,  110- 

"^  45. 

Brunton,  Sir  T.  Lauder,  9,  148. 

Bumps  of  the  brain,  46. 

Burns,  healed  by  skin  grafting,  101. 

Cabot,  Dr.  Richard  C,  his  attitude 
toward  vivisection,  134. 

Cancer,  abdominal,  32,  33, 185-88; 
of  the  larynx,  85;  of  the  esopha- 
gus, 90, 91 ;  of  the  pylorus,  91, 187; 
of  the  bowel,  95, 188;  ratio  of  per- 
manent cures,  163,  164;  mildly 
contagious,  164;  houses,  164; 
study  of,  164,  165;  amputation  of 
breast  for,  226. 

Cannon,  Dr.  W.  B.,  ix,  275,  276. 

Carbolic  acid,  to  prevent  suppura- 
tion. 207-11. 


Carnegie,  bacteriological  laboratory 
founded  by,  43. 

Carrel,  Dr.,  229;  his  services  in 
transfusion  of  blood,  156-58, 223- 
25;  Nobel  Prize  given  to,  157  n., 
262  n.;  his  work  on  the  aorta,  183, 
184;  experiment  of,  misrepre- 
sented, 268. 

Carroll,  Dr.,  229,  254. 

Catgut  ligatures,  75-78,  210,  211. 

Centers  of  the  brain,  37-39,  46-50; 
what  is  meant  by,  49;  accuracy  of 
localization  of,  62-70,  80. 

Cerebral  localization,  37-39,  46-50; 
accuracy  of,  62-70,  80. 

Cerebro-spinal  meningitis,  174;  two 
cases  contrasted,  220,  221;  mor- 
tality of,  before  and  after  Flex- 
ner's  serum,  221,  242;  lumbar 
punctures  for,  220,  221,  277.  _ 

Character,  influence  of  antivivisec- 
tion  on,  234-85. 

Chest,  surgery  of,  180^86,  260-63; 
contents  of,  180;  difficulties  of 
operation  on,  180, 181;  wounds  of 
great  blood  vessels  in,  184;  clot  in 
great  blood  vessels  in,  185. 

Chiene,  Professor,  his  method  of 
finding  the  angle  of  the  fissure  of 
Rolando,  50. 

Childbed  fever,  before  and  after 
antisepsis,  215,  227,  255-57.  287. 

Chloroform,  74, 103, 104;  when  first 
used  in  surgery,  172;  relative 
danger  of,  172. 

Cholera,  experiments  on,  with  mice 
and  wells,  15,  16. 

Christison  and  Calabar  bean,  3. 

Circulation  reestablished  after 
death,  154. 

Citations  from  medical  articles,  de- 
tached, 130.  See  Quotations, 
References. 

Civil  War,  surgery  of,  203,  225. 

Clement,  E.  H.,  134. 

Clinical  observation  r*.  experimental 
research,  xi,  xii. 

Clots,  156,  157,  223,  224;  in  great 
blood  vessels  of  chest,  185. 

Coagulation  time  of  blood,  104. 

Cobbe,  Frances  Power,  misstate- 
ments in  her  book.  132,  247,  248, 
266-68. 

Cocain,  3,  10,  72;  in  the  surgery  of 


304 


INDEX 


the  eye,  172;  infiltration  of,  172, 
173;  and  adrenalin,  mixture  of, 
173;  injection  of,  into  nerves,  be- 
fore dividing,  173,  174;  injection 
of,  into  sheath  of  spinal  cord, 
175. 

Cold  storage  of  tissues  for  trans- 
plantation, 162. 

Coleridge,  Stephen,  and  the  speed 
limit,  263,  264;  false  statement  of, 
in  regard  to  Pasteur  institutes, 
264,  265. 

Colic,  gall-stone,  250  n. 

Compound  fractures,  20,  23,  29, 
203,  207,  215,  287. 

Consumption,  galloping,  120,  121; 
germs  of,  and  tuberculin  inocula- 
tions, 129-32,  144.  See  Tubercu- 
losis. 

Cretinism,  thyroid  extract  in,  133, 
134;  as  result  of  operation  for 
goiter,  166. 

Crile,  Dr.,  229;  experiments  of, 
anesthetics  used  in,  vi,  vii;  and 
Mrs.  Henderson,  vi,  vii;  awarded 
American  Medicine  Gold  Medal 
for  1914,  vii;  services  in  transfu- 
sion of  blood,  156,  159,  224. 

Cromer,  Lord,  233. 

Cruelty  to  human  beings,  fostered 
by  antivivisection,  250-63. 

Cuba,  17  n.,  169,  229. 

dushing.  Dr.  Harvey,  195  n. 

Deutsches  Volkshlatt,  119. 

Diagnosis,  of  brain  tumor,  14, 53-57; 
of  abscess  in  the  brain,  51-53;  of 
hemorrhage  inside  the  skull,  59, 
60,  146-48,  230;  of  mental  dis- 
'  orders,  60,  61;  of  causes  of  epi- 
lepsy, 62-70;  experiments  to  aid, 
106-09;  of  consumption,  by  tuber- 
culin, 131,  144;  lumbar  puncture 
for,  174,  274-77;  of  cancer,  187. 

Dickson,  Samuel,  opinion  by,  xiv, 

XV. 

Digitalis,  effects  of,  discovered  by 

experiment,  4  n.,  72. 
Diphtheria,  early  experiments  on,  8, 

9;  reduction  in  deaths  from,  due 

to  antitoxin,  9  n.,  73,  231,  232. 
Diseases,     among     animals,     107; 

germs  as  causes  of  specific,  how 

proved,  211-13. 


Doctors,  who  are  opposed  to  vivi- 
section, xii,  71;  experiment  on 
themselves,  16,  17,  169,  228,  229, 
254. 

Dog  stolen,  misleading  placard  eon' 
cerning,  271,  272. 

Dogs  from  a  "Philadelphia  Labo- 
ratory," 272,  286,  287. 

Drugs,  value  of  new,  discovered  by 
experiments  on  animals,  4. 

Ductless  glands,  194. 

Dudgeon,  Dr.  R.  E.,  118. 

Duke  of  Newcastle  and  hydropho- 
bia, 107. 

Dying  person  ought  not  to  be  saved, 
273. 

Eliot,  C.  W.,  quoted  on  interference 
with  necessary  processes  of  medi- 
cal investigation,  132;  inscription 
on  Lazear's  tablet,  170,  229. 

England,  antivivisection  laws  in,  9, 
12,  19,  28,  148,  149,  208;  real 
opinion  of  medical  profession  of, 
as  to  value  of  vivisection,  xv,  71. 

Epilepsy,  36,  37,  62-70. 

Ergot,  effects  of,  discovered  by  ex- 
periment, 4  n. 

Erysipelas,  24,  202,  204,  216. 

Esophagus,  cancer  of,  90,  91 ;  sur- 
gery of,  90-92. 

Ether,  74,  103,  104;  sleep  of,  107, 
108;  first  demonstration  of,  172; 
relative  danger  of,  172. 

Exophthalmic  goiter,  167. 

Exhibition,  antivivisection,  in  New 
York,  271;  in  Philadelphia,  271, 
272,286-90. 

Exhibitions,  antivivisection,  no 
etherizer  shown  in,  viii. 

Experiment,  what  is  an,  x,  xi;  age  of, 
284. 

Experimental  research  vs.  clinical 
observation,  xi,  xii. 

Experiments,  performed  with  anes- 
thetics, vi-viii,  108, 232,  233,  244- 
46,  265-68,  273,  278,  279,  286;  on 
animals,  feasible  method  of  prog- 
ress, X,  xi;  necessary  to  progress, 
x,  xi,  2,  284,  289,  290;  by  doctors 
on  themselves,  16,  17,  169,  228, 
229, 254;  to  aid  diagnosis,  106-09; 
recent  surgical  progress  chiefly 
result  of,  22,  45, 151-70, 199-219; 


INDEX 


805 


era  of  precise,  218,  219;  painful- 
ness  of,  statistics,  241,  244,  245, 
262,  263,  266;  by  students,  245; 
on  sciatic  nerve,  247,  248;  to  be 
tested  first  on  man,  according  to 
Mrs.  White,  251-53;  on  human 
beings,  advocated  by  United 
States  Senator,  253.  See  Progress, 
Vivisection. 

Exploratory  operations,  31,  32. 

Eye,  cocain  in  surgery  of,  172. 

Face,  paralysis  of,  operation  for,  179. 

Facial  nerve,  179. 

Fahs,  Mr.,  letter  to  Life,  296,  297. 

Federation  of  American  Societies 
for  Experimental  Biology,  reso- 
lution of,  xvi. 

Fergusson,  Sir  William,  xiii. 

Ferrier,  Sir  David,  12,  13. 

Fever,  8;  heat,  8;  typhoid,  103,  258- 
60;  puerperal,  215,  227,  255-257, 
287;  after  abdominal  operations, 
250  n. 

Final  collapse,  124,  125,  140,  279. 

Finger,  Prof.  E.,  118. 

Fischer,  his  paper  on  wounds  of  the 
heart,  151. 

Flexner,  229;  his  serum  for  cerebro- 
spinal meningitis,  221,  242. 

Foreign  bodies  in  windpipe,  181, 
182. 

Fourth  of  July  tetanus,  197,  198. 

Fowler's  position  in  peritonitis,  192. 

Fractures,  simple  and  compound, 
22,  23,  203;  compound,  mortality 
of,  29,  215,  287;  of  the  spine,  41; 
Lister's  experiments  on  com- 
pound, 207. 

Gag.   See  Mouth  gag. 

Gall-bladder,  removal  of,  6;  opera- 
tions on,  33,  191. 

Gall-stone  colic,  250  n. 

Gall-stones,  33,  191,  250  n. 

Gallinger,  Senator  Jacob  H.,  110, 
111,  117;  letter  to,  146-49. 

Galloping  consumption,  120,  121. 

Gangrene,  hospital,  x,  24,  202-04, 
215,  216,  226;  from  tying  of  arter- 
ies, 79,  155,  156;  of  the  lung,  181. 

Garbling  of  quotations,  110,  112, 
113,  115,  119-32,  139-43. 

General  anesthesia,  171, 172. 


Gentleness,  need  for,  in  handling  the 
intestine,  190. 

Gerlach,  his  experiments  on  tuber- 
culosis, 15. 

Germ  theory,  well  established,  250. 

Germs,  of  consumption,  and  inocu- 
lations with  tuberculin,  129-32; 
cannot  rise  against  gravity,  205- 
07;  suppuration  and  inflammation 
caused  by,  207,  213;  as  causes  of 
specific  diseases,  how  proved,  211- 
13;  how  killed,  213. 

Gettysburg,  battle  of,  secondary 
hemorrhage  after,  202. 

Gigantism,  195. 

Glands,  ductless,  194. 

Glasgow,  antiseptic  method  in  Royal 
Hospital  in,  216-18;  description 
of  conditions  in  Royal  Hospital 
in,  216-18. 

Godlee,  Sir  Rickman  J.,  35. 

Goiter,  mortality  of,  42,  84,  165, 
166;  operations  for,  83,  84,  166; 
use  of  thyroid  extract  for,  85;  and 
parathyroid  glands,  166,  167;  ex- 
ophthalmic, 167. 

Gorgas,  Colonel,  17  n.,  169,  228. 

"Grafting"  of  severed  parts,  43, 
156;  of  skin,  100-02,  160. 

Graves's  Disease,  167,  168. 

Gross,  Prof.  Samuel  D.,  199. 

Guthrie,  Dr.,  156,  162,  163. 

Hadwen,  Dr.,  249,  250. 

Halle,  antiseptic  method  in  hospi- 
tal in,  216. 

Halsted,  his  experiments  misrepre- 
sented, 267. 

Hand,  right,  center  for,  65,  66. 

Heart,  surgery  of,  151-54;  sutvu-e  of, 
151,  152;  pulsation  of,  reestab- 
lished long  after  death,  152,  153; 
valvular  disease  of,  153;  opera- 
tions on  valves  of,  153,  154. 

Heat  fever,  8. 

Hell  at  Close  Range,  242. 

Hell  of  the  Innocent,  247,  248. 

Hemoglobin,  103. 

Hemorrhage,  secondary,  24,  201, 
202;  within  the  skull,  36,  57-60, 
81,  146-48,  230;  Lister's  experi- 
ments in,  75-77;  one  night  of,  75; 
how  arrested,  before  and  after 
antisepsis,    77,    78;    sewing    of 


S06 


INDEX 


artery  to  avoid,  78,  79;  internal, 
vs.  shock,  105,  106;  of  the  new- 
born, 157,  223. 

Henderson,  Mrs.,  on  CrUe's  experi- 
ments, vi,  vii. 

Hernia,  operation  for,  192-94. 

Hip- joint,  amputation  at,  225. 

Holmes,  O.  W.,  256. 

Horsley,  Sir  Victor,  and  brain  sur- 
gery, 36;  his  method  of  localizing 
cerebral  functions,  38;  and  spinal 
surgery,  41;  his  experiments  mis- 
represented, 265. 

Hospital  for  experiments  on  human 
beings,  242,  243. 

Hospital  gangrene,  x,  24,  202-04, 
215,  216,  226. 

Hospitals,  antiseptic  method  in 
three,  215-18. 

Hughes,  Charles  E.,  Jr.,  case  of,  220, 
221,  277. 

Human  beings,  cruelty  to,  fostered 
by  antivivisection,  250-63. 

Human  vivisection,  cry  of  the  anti- 
vivisectionists,  ix;  Drs.  Mitchell, 
Morehouse,  and  Keen  accused  of, 
ix,  236  n. ;  correspondence  regard- 
ing, 110-45;  advocated  by  Mrs. 
White,  251-53,  294;  advocated 
by  Mrs.  Lovell  and  Dr.  Snow, 
252  n.;  advocated  by  United 
States  Senator,  253. 

Human  Vivisection,  ix,  136-42, 236  n, 
279. 

Humanity,  what  vivisection  has 
done  for,  220-33.   See  Progress. 

Hydrophobia,  20,  97;  discovery  of 
germ  of,  98  n.;  and  Duke  of  New- 
castle, 107. 

"Hyena,"  289. 

Hypoglossal  nerve,  180. 

Hypophysis,  surgery  of,  194-96, 
287;  an  operation  on,  288. 

Hysterectomy,  287. 

Inaccuracy  of  statements,  110, 112, 
115,  119-32,  139. 

India,  mortality  from  snake- bites 
in,  9;  antidote  for  snake  poisons 
in,  9,  148,  149;  experiments  from 
snake-bites  in,  advocated,  252, 
294. 

Infantile  paralysis,  242,  282. 

Infection,  to  what  due,  22,  23. 


I  Infiltration  of  cocain,  172,  173. 

Inflammation,  22,  23,  199;  re- 
searches on,  17,  18;  discovery  of 
germs  of,  75;  the  cause  of,  207, 
213. 

Inoculation,  of  yellow  fever,  Sana- 
relli's  experiments  on,  124-26; 
with  tuberculin,  129-32. 

Insane,  Dr.  Berkley's  experiments 
on,  120,  121;  vivisection  experi- 
ments upon,  142. 

Insane  Asylum  at  Voralberg,  119. 

Insufflation,  tracheal,  183. 

Internal  secretions,  194. 

International  Medical  Congress, 
resolution  of,  xvi. 

Intestines,  wounds  of,  5,  6,  30,  95; 
surgery  of,  33,  94-97,  188-90; 
and  stomach,  united,  91,  93; 
tumor  of,  94,  95;  typhoid  per- 
foration of,  96,  189;  how  much 
can  be  removed,  96,  97;  cancer  of, 
188;  rupture  of,  188;  need  for 
gentleness  in  handling,  190;  mor- 
tality of  wounds  of,  in  Civil  War, 
225. 

Jansen,  Dr.,  lecture  of,  118,  119, 
141,  142. 

Jobling,  Dr.,  221,  225. 

Joints,  transplantation  of,  161. 

Journal  of  Zobphily,  243, 243  n.,  257, 
263,  268,  274-76;  advocates  vivi- 
section, 252  n. 

Keen,  Dr.  William  W.,  accused  of 
human  vivisection,  ix,  236  n. ;  cor- 
respondence of,  with  the  Ameri- 
can Humane  Association,  110- 
45;  open  letter  of,  to  Senator 
Gallinger,  146-49;  false  charge 
against,  242;  on  opinion  of  medi- 
cal profession  and  of  societies  on 
vivisection,  295. 

Kelly,  Dr.  Howard  A,,  his  book, 
Walter  Reed  and  Yellow  Fever,  228. 

Kidney,  Simon's  experiments  on, 
11,  87;  surgery  of,  11,  12,  34,  87, 
88;  removal  of,  results  in  saving 
life,  11,  34,  88;  tumor  of,  158, 159; 
transplantation  of,  in  cat,  163. 

Knee-joint,  transplantation  of,  161. 

Knock-knee,  42. 

Knopf,  Dr.  S.  A.,  prize  essay  of,  145. 


INDEX 


307 


Koch,   his   discovery   of   germ   of 

tuberculosis,  14,  15,  144. 
Krause  and  skin-grafting,  160. 
Kroenig,  experiments  of,  120,  128. 

Laboratories,  visitors  not  excluded 
from,  viii,  ix;  closed  doors  of,  viii, 
ix;  conditions  under  which  re- 
searches are  made  in,  245,  246; 
rules  of,  246;  Philadelphia,  vivi- 
sected products  of,  272,  286. 

Larynx,  surgery  of,  85. 

Laudable  pus,  199. 

Lawrence,  Bishop,  159. 

Lazear,  Dr.,  death  and  tablet,  170, 
229  254. 

Leffingwell,  Dr.  Albert,  115  n.,  271. 

Leg,  transplantation  of,  in  dog, 
163. 

Leidig,  Dr.  Eugen,  118. 

Letter,  of  Mr.  Brown  to  Dr.  Keen, 
110-13;  of  Dr.  Keen  to  Mr. 
Brown,  114-32;  of  Dr.  Keen  to 
Hon.  Jacob  H.  GaUinger,  146^9; 
from  Los  Angeles,  234-36;  of  Mr. 
Fahs,  296,  297. 

Letters  of  abuse,  234-39. 

Leucocytosis,  102,  103. 

Lexer,  his  operations,  161. 

Life,  Berkley  8  letter  to,  121;  Mr. 
Fahs's  letter  to,  296,  297. 

Ligatures,  silk  and  catgut,  23,  75- 
78,  200,  201,  208-11;  of  carbolized 
silk,  208-11.^ 

Light  anesthesia,  vii,  244. 

Lister's  services  to  antisepsis,  18, 
19,  225-27,  255;  obliged  to  go  to 
Toulouse  to  experiment,  19,  28, 
148,  208;  his  experiments  in  hem- 
orrhage, 75-77, 148;  quoted  on  re- 
sult of  operation  for  hernia,  193, 
194;  his  experiments  with  urine, 
205-07;  his  experiments  on  sup- 
puration, 207,  208;  his  experi- 
ments on  arteries,  208-11;  suc- 
cess of  antiseptic  method  in 
Royal  Hospital  in  Glasgow,  216- 
18;  the  maker  of  modern  sur- 
gery, 252;  application  of  his  anti- 
septic method  to  obstetrics,  257. 

Liver,  operations  on,  34,  86,  87, 190, 
191;  tumors  of,  191. 

Local  anesthesia,  172-74. 

Localization    of    function    in    the 


brain,  37-39,  46-50;  accuracy  of, 

62-70,  80,  146-48. 
Lockjaw,   See  Tetanus. 
Los  Angeles,  letter,  234-36. 
Lovell,  Mrs.,  advocates  vivisection, 

252/1. 
Lumbar  puncture,  122-24, 174,  220, 

221,  274-77;  results  of,  277,  278. 
Lungs,  surgery  of,  41,  42,  85,  86, 

180-86;  ventilation  of,  183. 

Malaria,  experiments  to  determine 
origin  of,  15. 

Mastoid  operation,  179. 

Matas's  operation  for  aneurysm,155. 

Medical  articles,  detached  citations 
from,  130. 

Medical  Press  and  Circular y  quoted, 
126,  127. 

Medical  profession,  collective  opin- 
ion of,  on  vivisection,  xv-xviii, 
295. 

Medicine,  progress  in,  how  attained, 
X,  xi,  2,  284;  contributions  to,  in 
America  through  vivisection,  5, 
6,  8.   See  Progress. 

Meltzer  and  Auer's  method  of  anes- 
thesia, 183,  261. 

Menge,  experiments  of,  127,  128. 

Meningitis,  several  forms  of,  277, 
278.  SeeCerebro-spinal  meningitis. 

Mental  disorders,  operation  for,  60, 
6L 

Mesentery,  gunshot  wounds  of,  5,  6. 

Meyer,  Dr.  Willy,  his  chamber  for 
surgery  of  chest,  183. 

Midland  Medical  Society  and  Law- 
son  Tait,  xiii. 

Misrepresentations  due  to  antivivi- 
sectionists,  vi-ix,  120-45,  263-90, 

Missionaries  and  snake-bites,  9  n. 

Misstatements  of  antivivisectionists, 
vi,  110-45,  244,  263-90. 

Mitchell,  Dr.  Weir,  9;  accused  of 
human  vivisection,  ix,  236  n.;  at 
Antivivisection  Exhibition  in 
Philadelphia,  284. 

Morehouse,  Dr.,  accused  of  human 
vivisection,  ix,  236  n. 

Morton,  and  ether,  172. 

Mosquito,  admiration  for,  254,  255, 

Mouth-gag,  used  "to  break  the 
jaws,"  269;  in  a  child's  mouth, 
,269,  270.^ 


308 


INDEX 


Munich,  General  Hospital  in,  anti- 
septic method  in,  215,  216. 

Murder,  scientific,  125,  279. 

Murders  not  murders,  125,  140. 

Musculo-spiral  nerve,  in  arm,  177, 
178. 

Myxedema,  84. 

Nature,  clumsy  experiments  by,  in 
disease,  39,  40. 

Neisser,  experiments  of,  126,  127. 

Nerve,  musculo-spiral,  in  arm,  177, 
178;  of  face,  operation  on,  179; 
the  hypoglossal,  180;  the  spinal 
accessory,  180. 

Nerves,  surgery  of,  83,  177-80;  in- 
jection of  cocain  into,  before 
dividing,  173,  174;  suture  of,  177; 
of  arm,  and  birth  palsies,  178, 
179. 

New  England  Antivivisection  So- 
ciety, 248. 

Newcastle,  Duke  of,  and  hydro- 
phobia, 107. 

Newspapers  as  authorities,  116-18, 
138. 

Nine  Circles,  The,  false  statements 
in,  247,  248,  265,  271. 

Nitrous  oxid,  172. 

"No  matter  how  great  the  benefit," 
243,  257. 

Nobel  Prize,  given  to  Dr.  Carrel, 
157  n.,  262  n. 

Nose,  the  making  of  a  new,  100, 161; 
made  from  shin  bone,  162,  171. 

Novocain,  175. 

Obstetrics,  before  and  after  antisep- 
sis, 215,  227,  255-57,  287. 

Oilier,  and  transplantation  of  bone, 
160. 

Operation  described  which  was 
never  done,  270,  271. 

Organs,  transplantation  of,  160-63. 

Ott,  Dr.  Isaac,  3;  his  experiments 
misrepresented,  266,  267. 

Ovariotomy,  mortality  of,  7,  32, 
214,  255,  287. 

Painfulness,  of  experiments,  statis- 
tics, 12  n.,  108,  241,  244,  245,  262, 
263,  266;  of  gall-stones,  250  n. 

Pamphlets  on  vivisection,  xix,  xx. 

Panama  Canal  Zone,  17  «.,  169, 228. 


Paralysis,  due  to  removal  of  brain 
center,  not  always  permanent,  68, 
69;  infantile,  242,  282. 

Parathyroid  glands,  166,  167,  194. 

Pasteur,  his  experiments,  20,  97; 
and  childbed  fever,  227,  255,  257; 
Life  of,  255. 

Pasteur  Institutes,  20,  97;  false 
statement  of  Stephen  Coleridge 
regarding,  264,  265. 

Pearce,  Dr.  R.  M.,  viii,  ix. 

Pennsylvania,  University  of,  prose- 
cution of  six  professors  of,  xiv,  xv. 

Perforation  of  intestine  in  typhoid, 
96,  189. 

Periosteum,  production  of  new  bone 
from,  98-102,  160,  161. 

Peritoneum,  operations  on,  7,  29. 

Peritonitis,  192. 

Phenol.   See  Carbolic  acid. 

Philadelphia,  Antivivisection  Exhi- 
bition in,  271,  272,  286-90;  labo- 
ratories, vivisected  products  of, 
272,  286. 

Phthisis.  See  Consumption,  Tuber- 
culosis. 

Pituitary  body,  surgery  of  the,  194- 
96,  287;  an  operation  on,  288. 

Playfair,  Sir  Lyon,  258. 

Pleurisy,  181. 

Postal  cards  issued  by  the  American 
Antivivisection  Society,  269. 

Pre-antiseptic  surgery,  23,  24,  199- 
204. 

Pre-Listerian  surgery,  23,  24,  199- 
204. 

Professors,  six,  of  University  of 
Pennsylvania,  prosecution  of, 
xiv,  XV. 

Progress,  experiments  on  animals  a 
feasible  method  of,  x,  xi;  and  ani- 
mal experimentation,  2,  22,  43, 
45,  72-75,  151,  168-70,  219,  220- 
33,  289,  290;  age  of,  284. 

Prosecution  of  six  professors  of  Uni- 
versity of  Pennsylvania,  xiv,  xv. 

Puerperal  fever.  See  Childbed  fever. 

Puncture,  lumbar,  122-24, 174,  220, 
221,  274-77;  results  of,  277,  278. 

Purulent  bacteria,  128. 

Pus,  199,  200. 

Putrefaction,  204-06,  212. 

Pyemia,  in  Civil  War,  203;  disap- 
pearance of,  since  antisepsis,  2()4. 


INDEX 


309 


Pylorus,  cancer  of,  91,  187;  surgery 
of,  91,  93. 

Quotations,  in  pamphlet  of  Ameri- 
can Humane  Association,  garbled 
and  inaccurate,  110,  112,  115, 
119-32,  139;  selected.  293-95. 

Rabbits,  Sir  James  Simpson's  life 
saved  by  experiments  on,  258. 

Reality  of  Human  Vivisection,  The, 
135-45. 

Reed,  Dr.,  17  n. ;  letter  to  his  wife, 
229. 

References  in  pamphlet  of  American 
Humane  Association,  vague  and 
indefinite,  110-20,  138-40. 

Reichert,  Dr.,  9.^ 

Remedies,  new,  discovered  by  exper- 
iment, 4,  25. 

Repetitions,  reasons  for,  v. 

Research,  achievements  of  friends 
of,  280-83;  achievements  of  foes 
of,  283-85. 

Resolutions,  of  British  Medical  As- 
sociation and  Midland  Medical 
Society,  xiii;  of  British  Medical 
Association,  xv,  xvi,  71;  of  Inter- 
national Medical  Congress,  .xvi; 
of  Federation  of  American  Socie- 
ties for  Experimental  Biology, 
xvi;  of  American  Medical  Asso- 
ciation and  American  Association 
for  the  Advancement  of  Science, 
xvii,  xviii;  against  vivisection, 
not  one  from  any  scientific  society, 
xviii. 

Respiration,  Meltzer  and  Auer's 
method  of,  183,  261. 

Reverdin,  and  skin-grafting,  160. 

Richardson,  Dr.  Maurice  H.,  his 
attitude  toward  vivisection,  134. 

Roberts,  Dr.  John  B.,  151. 

Rockefeller  Institute,  discoveries  at, 
221-25,  242,  247,  261,  282  n.,  ob- 
ject of  antivivisectionists'  wrath, 
238,  243,  283. 

Rolando,  fissure  of,  48-50. 

Royal  Commission  on  Vivisection, 
denial  by,  of  torture  in  vivisec- 
tion, xviii,  233,  241,  247,  294. 

Rules  of  laboratories,  246. 

Rupture,  operation  for,  192-94. 

Rupture  of  intestine,  188. 


Salt  solution,  injection  of,  154,  249. 

Sanarelli,  his  experiments  on  the 
inoculation  of  yellow  fever  mis- 
represented, 124-26,  143,  144, 
279. 

Sauerbruch's  chamber  for  surgery 
of  chest,  182,  184,  261. 

Schreiber,  Professor,  experiments 
of,  129-32. 

Sciatic  nerve,  experiments  on,  247, 
248;  and  spinal  cord,  248. 

Scientific  assassination,  125,  279. 

Scientific  bodies,  attitude  of,  toward 
vivisection,  xv-xviii,  295. 

Scientific  murder,  125,  279. 

Secondary  hemorrhage,  24,  201, 202. 

Senn,  Dr.,  his  experiments  misrepre- 
sented, 267. 

Septic  processes,  22;  illustration  of, 
23,  24;  mortality  in  amputations 
under,  27. 

Seventh  nerve,  179. 

Sheen,  Dr.  Rodman  E.,  case  of,  288. 

Sherrington,  Prof.  G.  S.,  operations 
of,  on  dead  animals,  misrepre- 
sented, 265,  293,  294. 

Shin  bone,  transplantation  of,  161, 
171. 

Shock  vs.  internal  hemorrhage,  105, 
106. 

Silk,  ligatures  of,  23,  75-78;  car- 
bolized,  ligatures  of,  208-11. 

Simon,  his  experiments  on  the  kid- 
ney, 11,  87,  88. 

Simple  fractures,  22,  23,  203. 

Simpson,  Sir  James,  and  chloroform, 
172  ;  his  life  saved  by  Playfair's 
two  rabbits,  258. 

Skin  grafting,  100-02,  160. 

Skull,  hemorrhage  within,  57-60, 81. 
See  Brain. 

Sleeping  sickness,  283. 

Smallpox  pus,  142. 

Smith,  Prof.  Robert  Meade,  20. 

Snake-bites,  mortality  from,  in 
India,  9;  need  of  an  antidote  for, 
9, 148, 149;  and  missionaries,  9  n.; 
experiments  on  sufferers  from  in 
India  advocated,  252. 

Snow,  Ellen,  242. 

Snow,  Dr.  Herbert,  his  ignorance 
on  vivisection  question,  247,  250, 
295;  advocates  vivisection,  252  n., 
295. 


310 


INDEX 


Societies,  scientific,  their  attitude 
toward  vivisection,  xiii-xviii,  71, 
295;  anti vivisection,  bequests  to, 
f280. 

Society,  American  Antivivisection, 
269,  289. 

Speed  limit  and  Stephen  Coleridge, 
264. 

Spina  bifida,  99. 

Spinal  accessory  nerve,  180. 

Spinal  anesthesia,  174-76,  278. 

Spinal  cord,  total  division  of,  81,  82; 
tumors  of,  82;  and  sciatic  nerve, 
248. 

Spine,  surgery  of,  41. 

Spleen,  removal  of,  6,  33,  87. 

Stewart,  Dr.  Francis  T.,  151. 

Stomach,  removal  of,  6,  32,  90,  94, 
187;  wounds  of,  30;  cancer  of,  32, 
33,  185-88;  surgery  of,  88-94; 
mortaUty  of  sewing  of,  91;  and 
bowel,  united,  91,  93;  operations 
on,  for  adhesions,  92;  foreign  bod- 
ies in,  92;  permanent  opening 
into,  92,  93;  dilated,  taking  a 
"tuck"  in,  93;  displaced,  93,  94; 
like  an  "hour-glass,"  94;  tumors 
of,  94;  perforation  of,  by  ulcer, 
96,  186;  ulcer  of,  186-88. 

Stovain,  175. 

Streptococcus,  227. 

Students,  experiments  by,  245. 

Subperiosteal  removals,  161. 

Sunstroke,  nature  and  effects  of,  8. 

Suppuration,  22,  23,  199,  200;  the 
cause  of,  207,  213;  Lister's  experi- 
ments on,  207,  208. 

Suprarenal  gland,  194. 

Surgery,  recent  progress  in,  22-44; 
of  the  brain,  45-71 ;  the  progress 
of,  as  influenced  by  vivisection, 
72-109;  recent  progress  in,  a  re- 
sult chiefly  of  experimental  re- 
search, 151-70; the  new,  171-98; 
modem  antiseptic,  and  experi- 
mentation, 199-219.  See  Heart, 
Lungs,  etc. 

Surgical  fever,  24. 

Suture,  defined,  24;  of  the  heart, 
151,  152;  of  artery,  155-57;  of 
nerves,  177;  of  blood-vessels,  158, 
223. 

Sylvius,  fissure  of,  48. 

Syme,  Mr.,  207. 


Syphilis,  clinical  observation  vs.  ex- 
periments, xi,  xii;  experiments 
on,  123,  124.,^ 

Tait,  Lawson,  recantation  of,  xii, 
xiii,  71,  293. 

Ten  coffins,  tragedy  of,  255. 

Tertullian,  118.1 

Tetanus,  germ  of,  74, 196,  197,  212; 
since  antisepsis,  197,  204;  on 
Fomi:h  of  July.  197,  198;  in  CivU 
War,  203,  225. 

Tetany,  166. 

Thermic  fever,  8. 

Thiersch,  his  experiments  on  chol- 
era, 15,  16. 

Thigh,  nose  made  from  bone  of,  162; 
transplantation  of,  163. 

Thumb,  center  for,  66-68,  80. 

Thymus  gland,  194. 

Thyroid  extract,  84,  85,  120,  121; 
in  cretinism,  133,  134. 

Thyroid  gland,  194;  operations  on, 
84,  166. 

Tomkins,  Rev.  Dr.  Floyd  W., 
quoted,  234. 

Tommasi-Crudeli,  his  experiments 
on  malaria,  15. 

Torture  of  animals,  denial  of,  by 
Royal  Commission  of  Vivisection, 
241,  294;  by  students,  denial  of, 
245. 

Toulose,  Lister  obliged  to  go  to,  to 
experiment,  19,  28,  48,  208. 

Toynbee,  lost  his  life  by  experi- 
menting, 3. 

Tracheal  insufflation,  183. 

Tracy,  A.,  115, 121, 136, 143, 144. 

Transfusion  of  blood,  157-59,  223, 
224,  242. 

Transplantation,  of  bone,  98-102, 
160-62, 171;  of  skin,  101-02, 160; 
to  form  new  nose,  100,  161,  162; 
of  parts  of  body  and  organs,  160- 
63;  of  joints,  161;  of  arteries  after 
cold  storage,  162;  of  leg  of  dog, 
162;  of  kidney  of  cat,  163;  of  para- 
thyroid glands,  167. 

Trephining,  225. 

Treves,  Sir  Frederick,  misrepre- 
sented, 232,  268,  269;  his  testi- 
mony to  value  of  vivisection,  293. 

Trichina,  17,  72. 

Tropacocain,  175. 


INDEX 


311 


Truthfulness,  lessened  reverence  for, 
263-79. 

Tuberculin  inoculations,  129-32, 
144. 

Tuberculosis,  discovery  of  germ  of, 
14,  15;  bacteriology  of,  73;  tuber- 
culin test  for,  131,  144.  See  Con- 
sumption. 

Tuberculous  meningitis,  174. 

"Tuck,"  taken  in  the  stomach,  93. 

Tumors,  of  the  brain,  diagnostica- 
tion  and  removal  of,  13,  14,  35, 
53-57,  63,  64,  174,  215;  abdomi- 
nal, 31,  32;  of  the  spine,  41 ;  of  the 
brain,  statistics  of,  56,  57;  of 
spinal  cord,  82;  of  the  liver,  86, 
87;  of  the  stomach,  94;  of  the 
bowel,  94,  95;  of  the  kidney,  158, 
159;  and  skin-grafting,  160;  of  the 
liver,  191 ;  of  pituitary  body,  195. 

Typhoid  fever,  condition  of  blood 
in,  103;  vaccination  against,  258- 
60;  abolished  in  our  army,  259, 
260;  vaccination  in  British  Army, 
260  n. 

Typhoid  perforation  of  intestines, 
96,  189. 

Ulcer,  perforation  of  stomach  by, 
96;  and  skin-grafting,  160;  of  the 
stomach,  186,  188. 

University  of  Pennsylvania,  prose- 
cution of  six  professors  of,  xiv, 

XV. 

Urine,  Lister's  experiments  with, 
205-07. 

Vaccination,  for  yellow  fever,  16; 
against  typhoid  fever,  258-60. 

Vallery-Radot,  Ren6,  his  Life  of 
Pasteur,  255. 

Valves  of  the  heart,  operations  on, 
153,  154. 

Veins,  surgery  of,  154-59. 

Ventilation  of  the  lungs,  183. 

Virchow,  his  experiments  on 
trichina,  17. 

Vivisected  products  of  Philadelphia 
laboratories,  272,  286. 

Vivisection,  objections  to  the  word, 
V,  vi;  use  of  anesthetics  in,  vi-viii, 
108,  232,  233,  244-46,  265-68, 
273,  278,  279,  286;  human,  ix, 
■  110-45.  236  n.,  251-53,  294;  doc- 


tors who  are  opposed  to,  xil,  71; 
resolutions  of  societies  regarding, 
xiii-xviii;  pamphlets  on,  xix,  xx; 
our  recent  debts  to,  1-21,  45,  72- 
109,  220-33;  new  remedies  dis- 
covered through,  4;  painfulness 
of,  12  w.,  108,  241,  244,  245,  262, 
263,  266;  its  contribution  to  treat- 
ment of  amputations  and  frac- 
tures, 19,  28;  animals  benefited 
by,  20, 109,  283,  289,  290;  its  con- 
tribution to  localization  of  brain 
centers,  37^1,  146-48;  brain  sur- 
gery and.  45-71;  opinion  of  med- 
ical profession  of  Great  Britain  as 
to  value  of,  71;  and  Midshipman 
Aiken,  146-50;  Royal  Commis- 
sion's denial  of  torture  in,  241, 
294;  no  resolutions  against,  by 
any  scientific  society,  xviii,  295. 
See  Experiments,  Progress,  Hu- 
man vivisection. 
Voralberg,  Insane  Asylum  at,  119. 

Warren,  Dr.  J.  Collins,  his  attitude 
toward  vivisection,  134. 

Warren,  John  C,  and  ether,  172. 

Wells,  Sir  Spencer,  7,  32,  172. 

Wentworth,  Dr.,  case  of,  122,  123, 
274-76;  results  of  his  researches, 
277. 

White,  Mrs.  Caroline  Earle,  her 
ignorance  of  surgery,  250  n.;  ad- 
vocates human  vivisection,  x, 
251-53,  294;  and  Su-  Frederick 
Treves,  268,  269;  "unconscious 
exaggeration"  of,  276  n.;  argues 
that  yellow  fever  has  not  been 
abolished,  281  n. 

Wilks,  Sir  Samuel,  203. 

Windpipe,  foreign  bodies  in,  181, 
182. 

Womb,  removal  of,  237. 

Women,  opposition  of,  to  experi- 
ments on  animals,  170,  222,  225; 
bitterness  of,  234-39. 

Wood,  Dr.  H.  C,  his  experiments  on 
the  efiFects  of  heat  on  animals,  8; 
his  experiments  on  the  effects  of 
bromid  of  ethyl  on  animals,  10. 

Wounds,  of  the  abdomen,  5,  6,  189; 
of  the  intestines,  5,  6,  30,  95;  of 
the  abdominal  organs,  30,  31 ;  of 
the  brain,  36;  of  the  heart,  151: 


312 


INDEX 


of  the  arteries  and  veins,  155;  of 
the  lung,  181 ;  of  great  blood 
vessels  in  chest,  184;  immediate, 
complete  closure  of,  208,  209. 

Wright,  Sir  Ahnroth,  259. 

Wrist-drop,  99. 


Yellow  fever,  abolishment  of,  ix,  x, 
281;  experiments  on,  and  discov- 
ery of  source,  16,  17,  228-30,  254, 
255.  281;  Walter  Reed's  letter  to 
hia  wife  as  to,  229;  experiments 
on  inoculation  of.  124-26.  279. 


CAMBRIDGE  .  MASSACHUSETTS 
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